Healthcare Provider Details

I. General information

NPI: 1114821865
Provider Name (Legal Business Name): MAAN DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3453 BROOKSIDE RD STE A
STOCKTON CA
95219-1788
US

IV. Provider business mailing address

4022 SUNRISE BLVD STE 120-131
RANCHO CORDOVA CA
95742-6911
US

V. Phone/Fax

Practice location:
  • Phone: 209-955-1500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: RASOOL MAAN
Title or Position: CEO
Credential: DDS
Phone: 925-699-2094