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General NPI Number Information
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NPI Number | 1568334910
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Entity Type | Organization
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Legal Business Name | IROSHINI PERERA D.D.S. INC DBA ELEVATE ORTHODONTICS
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 8505 BERG ST STE 150
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City | GRANITE BAY
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State | CA
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Zip | 95746-9067
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Country | US
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Telephone | 916-269-0001
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Fax | 916-269-0002
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Provider Business Mailing Address
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Address Line | 8505 BERG ST STE 150
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City | GRANITE BAY
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State | CA
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Zip | 95746-9067
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Country | US
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Telephone | 916-269-0001
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Fax | 916-269-0002
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Authorized Official
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Title or Position | PRESIDENT & ORTHODONTIST
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Name | IROSHINI JEANNE PERERA
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Credential | DDS, MSD
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Telephone | 408-368-1608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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