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General NPI Number Information
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NPI Number | 1376327239
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Entity Type | Individual
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Provider Name | ROJEAN GAENI
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Gender | Female
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Dates
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Enumeration Date | 08/22/2023
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 145 E 14TH ST # 100
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City | SAN LEANDRO
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State | CA
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Zip | 94577-1661
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Country | US
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Telephone | 510-587-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 2194 OCASO CAMINO
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City | FREMONT
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State | CA
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Zip | 94539-5646
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Country | US
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Telephone | 925-667-6381
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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 | 108312
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License Number State | CA
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