=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811841976
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RUCHI GOYAL DMD DENTAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/25/2026
-----------------------------------------------------
Last Update Date | 02/25/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 425 PINE ST
-----------------------------------------------------
City | GALT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95632-2055
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-745-4607
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2821 HAWAIIAN PETREL AVE
-----------------------------------------------------
City | MODESTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95355-8522
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 618-303-8238
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. RUCHI GOYAL
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 618-303-8238
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------