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General NPI Number Information
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NPI Number | 1366256885
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Entity Type | Individual
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Provider Name | PARVEEN POLIKI DDS
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Gender | Female
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 1800 TULLY RD STE A2
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City | MODESTO
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State | CA
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Zip | 95350-2923
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Country | US
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Telephone | 209-527-3990
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Fax |
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Provider Business Mailing Address
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Address Line | 4682 CHABOT DR P.O. BOX NO. 10191
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City | PLEASEANTON
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State | CA
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Zip | 94588
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 111106
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License Number State | CA
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