Provider Demographics
NPI:1013453794
Name:VASOYA DIPAKKUMAR DDS PC
Entity type:Organization
Organization Name:VASOYA DIPAKKUMAR DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIPAKKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:VASOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-258-1407
Mailing Address - Street 1:301 W 6TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3304
Mailing Address - Country:US
Mailing Address - Phone:951-258-1407
Mailing Address - Fax:
Practice Address - Street 1:301 W 6TH ST STE 105
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3304
Practice Address - Country:US
Practice Address - Phone:951-258-1407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA643111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty