Healthcare Provider Details

I. General information

NPI: 1922506807
Provider Name (Legal Business Name): RASHPAL DEOL DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2018
Last Update Date: 03/15/2024
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2276 CAMINO RAMON UNIT 150
SAN RAMON CA
94583-1353
US

IV. Provider business mailing address

3423 ASHBOURNE CIR
SAN RAMON CA
94583-6012
US

V. Phone/Fax

Practice location:
  • Phone: 925-735-6190
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number
License Number State

VIII. Authorized Official

Name: RASHPAL DEOL
Title or Position: PRESIDENT
Credential: DDS
Phone: 530-864-8449