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General NPI Number Information
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NPI Number | 1548155351
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Entity Type | Organization
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Legal Business Name | RAY DENTAL HOLDINGS PLLC.
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 09/21/2025
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Provider Practice Location Address
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Address Line | 1201 N LAKELINE BLVD STE 300
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City | CEDAR PARK
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State | TX
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Zip | 78613-6780
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Country | US
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Telephone | 312-607-1103
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 N LAKELINE BLVD STE 300
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City | CEDAR PARK
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State | TX
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Zip | 78613-6780
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Country | US
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Telephone | 512-456-7583
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | SHIPRA GUPTA
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Credential | DDS
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Telephone | 312-607-1103
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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 |
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License Number State |
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