Healthcare Provider Details

I. General information

NPI: 1407762180
Provider Name (Legal Business Name): ASHOK N VEERANKI DDS INC A PROFESSIONAL DENTAL COORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10399 FOOTHILL BLVD STE 106
RANCHO CUCAMONGA CA
91730-6957
US

IV. Provider business mailing address

10399 FOOTHILL BLVD STE 106
RANCHO CUCAMONGA CA
91730-6957
US

V. Phone/Fax

Practice location:
  • Phone: 402-805-4516
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: JENN HERITAGE
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 402-805-4516