Provider Demographics
NPI:1891171807
Name:RAHNAMAYI, ROYA (DDS)
Entity Type:Individual
Prefix:
First Name:ROYA
Middle Name:
Last Name:RAHNAMAYI
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 1:920 BIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6118
Mailing Address - Country:US
Mailing Address - Phone:530-208-0804
Mailing Address - Fax:
Practice Address - Street 1:920 BIDDLE RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6118
Practice Address - Country:US
Practice Address - Phone:541-326-4103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10560122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist