Healthcare Provider Details

I. General information

NPI: 1003699927
Provider Name (Legal Business Name): RISHIKA BHOOLABHAI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8527 SEPULVEDA BLVD
NORTH HILLS CA
91343-5824
US

IV. Provider business mailing address

7365 HILLSVIEW CT
WEST HILLS CA
91307-5202
US

V. Phone/Fax

Practice location:
  • Phone: 818-895-3100
  • Fax:
Mailing address:
  • Phone: 818-918-0519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number109095
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: