Provider Demographics
NPI:1023106549
Name:RANA, SAADIA A (DDS)
Entity type:Individual
Prefix:
First Name:SAADIA
Middle Name:A
Last Name:RANA
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 1:6687 N BLACKSTONE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-3524
Mailing Address - Country:US
Mailing Address - Phone:559-439-5231
Mailing Address - Fax:
Practice Address - Street 1:6687 N BLACKSTONE AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-3524
Practice Address - Country:US
Practice Address - Phone:559-439-5231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA516391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93147-01OtherMEDI-CAL
CAB51639-01OtherHEALTHY FAMILIES