Healthcare Provider Details

I. General information

NPI: 1275332645
Provider Name (Legal Business Name): REMYA NIRANJAN, A DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 N OLIVE AVE STE 2
TURLOCK CA
95382-2500
US

IV. Provider business mailing address

1810 N OLIVE AVE STE 2
TURLOCK CA
95382-2500
US

V. Phone/Fax

Practice location:
  • Phone: 209-632-8200
  • Fax: 209-632-6416
Mailing address:
  • Phone: 209-632-8200
  • Fax: 209-632-6416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. REMYA NIRANJAN
Title or Position: PRESIDENT
Credential: DDS
Phone: 408-439-3661