Healthcare Provider Details

I. General information

NPI: 1902737109
Provider Name (Legal Business Name): ANA NOURANIKHOSHKHO RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 BRANHAM LN STE 101
SAN JOSE CA
95136-1645
US

IV. Provider business mailing address

5727 PLAYA DEL REY APT 3
SAN JOSE CA
95123-2831
US

V. Phone/Fax

Practice location:
  • Phone: 408-978-8888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number36503
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: