Provider Demographics
NPI:1609171784
Name:NIKUNJ RAIYANI DDS PROF CORP
Entity Type:Organization
Organization Name:NIKUNJ RAIYANI DDS PROF CORP
Other - Org Name:HANFORD FAMILY DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIKUNJ
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAIYANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-530-8080
Mailing Address - Street 1:869 W LACEY BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-4328
Mailing Address - Country:US
Mailing Address - Phone:559-530-8080
Mailing Address - Fax:559-582-8064
Practice Address - Street 1:869 W LACEY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4328
Practice Address - Country:US
Practice Address - Phone:559-530-8080
Practice Address - Fax:559-582-8064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA546121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty