MEDICARE: RUHI SANGHA D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	61927	CA

General Provider Information

NPI Number	:	1548500267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUHI SANGHA D.D.S

Provider Business Mailing Address
First Line	:	3030 ASHBY AVE STE 101
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-2439
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 ASHBY AVE STE 101
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-2439
Country	:	US
Telephone Number	:	510-841-3040
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2013
Last Update Date	:	05/03/2018

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