Provider Demographics
NPI:1245240282
Name:MOSHAKE, RANA (DMD)
Entity type:Individual
Prefix:DR
First Name:RANA
Middle Name:
Last Name:MOSHAKE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:RANA
Other - Middle Name:
Other - Last Name:MOSHAKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:UCSB STUDENT HEALTH
Mailing Address - Street 2:588 BUILDING MC 7002
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93106-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UCSB STUDENT HEALTH
Practice Address - Street 2:588 BUILDING MC 7002
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-0001
Practice Address - Country:US
Practice Address - Phone:805-893-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA584471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice