MEDICARE: RUCHI GOYAL DMD DENTAL CORPORATION

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1811841976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUCHI GOYAL DMD DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	2821 HAWAIIAN PETREL AVE
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95355-8522
Country	:	US
Telephone Number	:	618-303-8238
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 PINE ST
Second Line	:
City	:	GALT
State	:	CA
Zip	:	95632-2055
Country	:	US
Telephone Number	:	209-745-4607
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RUCHI GOYAL
Credential	:	DMD
Telephone Number	:	618-303-8238

Provider Enumeration Date	:	02/25/2026
Last Update Date	:	02/25/2026

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