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General NPI Number Information
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NPI Number | 1326521055
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Entity Type | Organization
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Legal Business Name | RACHANA VYAS DDS INC
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 5150 GRAVES AVE STE 5C
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City | SAN JOSE
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State | CA
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Zip | 95129-5005
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Country | US
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Telephone | 408-725-1536
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Fax | 408-725-1021
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Provider Business Mailing Address
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Address Line | 5150 GRAVES AVE STE 5C
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City | SAN JOSE
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State | CA
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Zip | 95129-5005
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Country | US
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Telephone | 408-725-1536
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Fax | 408-725-1021
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Authorized Official
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Title or Position | OWNER
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Name | DR. RACHANA VYAS
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Credential | DDS
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Telephone | 408-725-1536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 56519
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License Number State | CA
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