Provider Demographics
NPI:1578588398
Name:SHINA, RANI (DDS)
Entity Type:Individual
Prefix:DR
First Name:RANI
Middle Name:
Last Name:SHINA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12285 SCRIPPS POWAY PKWY
Mailing Address - Street 2:#104
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-6149
Mailing Address - Country:US
Mailing Address - Phone:858-536-8111
Mailing Address - Fax:858-547-4193
Practice Address - Street 1:12285 SCRIPPS POWAY PKWY
Practice Address - Street 2:#104
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-6149
Practice Address - Country:US
Practice Address - Phone:858-536-8111
Practice Address - Fax:858-547-4193
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA465261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice