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General NPI Number Information
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NPI Number | 1790422970
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Entity Type | Individual
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Provider Name | RUCHIKA AGRAWAL DMD
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Gender | Female
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 3746 FALLON RD
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City | DUBLIN
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State | CA
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Zip | 94568-7400
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Country | US
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Telephone | 617-636-6828
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Fax |
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Provider Business Mailing Address
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Address Line | 253 LUCY CT
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City | FREMONT
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State | CA
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Zip | 94539-3911
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Country | US
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Telephone | 510-894-9740
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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 | DN1859483
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DDS110185
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License Number State | CA
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