Healthcare Provider Details

I. General information

NPI: 1609229244
Provider Name (Legal Business Name): EVERYDAY DENTAL A DENTAL CORPORATION OF RACHNA SURANA DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 07/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30021 ALICIA PKWY
LAGUNA NIGUEL CA
92677-2090
US

IV. Provider business mailing address

30021 ALICIA PKWY
LAGUNA NIGUEL CA
92677-2090
US

V. Phone/Fax

Practice location:
  • Phone: 949-363-5880
  • Fax:
Mailing address:
  • Phone: 949-363-5880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number StateCA

VIII. Authorized Official

Name: DANYELLE DEL PRADO
Title or Position: OFFICE MANAGER
Credential:
Phone: 949-363-5880