Provider Demographics
NPI:1861481509
Name:MAAHS, RANDALL ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:ROBERT
Last Name:MAAHS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2211 MOORPARK AVE
Mailing Address - Street 2:STE. 160
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2654
Mailing Address - Country:US
Mailing Address - Phone:408-993-2200
Mailing Address - Fax:408-993-1925
Practice Address - Street 1:2211 MOORPARK AVE
Practice Address - Street 2:STE. 160
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2654
Practice Address - Country:US
Practice Address - Phone:408-993-2200
Practice Address - Fax:408-993-1925
Is Sole Proprietor?:No
Enumeration Date:2005-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA228201223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery