MEDICARE: DR. RASHPAL S. DEOL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X2210X	Orofacial Pain Dentistry	DDS49089	CA
2	122300000X	Dentist	49089	CA
3	1223G0001X	General Practice Dentistry	49089	CA
4	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DDS49089	CA

General Provider Information

NPI Number	:	1619985892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RASHPAL S. DEOL DDS

Provider Business Mailing Address
First Line	:	2276 CAMINO RAMON STE 150
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1353
Country	:	US
Telephone Number	:	925-735-6190
Fax Number	:	925-735-6198

Provider Business Practice Location Address
First Line	:	2276 CAMINO RAMON STE 150
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1353
Country	:	US
Telephone Number	:	925-735-6190
Fax Number	:	925-735-6198

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	03/10/2024

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