Provider Demographics
NPI:1891395653
Name:RASHMI BEEDUBAIL DDS A PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:RASHMI BEEDUBAIL DDS A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:RASHMI
Authorized Official - Middle Name:
Authorized Official - Last Name:BEEDUBAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-524-8900
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:209-300-7651
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:209-300-7651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental