Provider Demographics
NPI:1629115423
Name:BEEDUBAIL, RASHMI (DDS)
Entity Type:Individual
Prefix:DR
First Name:RASHMI
Middle Name:
Last Name:BEEDUBAIL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 N CARPENTER RD STE 2
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95351-1199
Mailing Address - Country:US
Mailing Address - Phone:209-524-8900
Mailing Address - Fax:209-524-0178
Practice Address - Street 1:901 N CARPENTER RD STE 2
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95351-1199
Practice Address - Country:US
Practice Address - Phone:209-524-8900
Practice Address - Fax:209-524-0178
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA205041243OtherDDS