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General NPI Number Information
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NPI Number | 1659283422
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Entity Type | Organization
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Legal Business Name | PATHAK DENTAL CORPORATION
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Dates
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Enumeration Date | 09/17/2026
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 4168 N SIERRA WAY
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-3819
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Country | US
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Telephone | 909-886-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 1142 S DIAMOND BAR BLVD # 624
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City | DIAMOND BAR
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State | CA
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Zip | 91765-2203
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Country | US
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Telephone | 714-310-5160
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROHAN PATHAK
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Credential | DDS
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Telephone | 714-310-5160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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