MEDICARE: ISHAYA 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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1861357196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISHAYA DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	1801 COLORADO AVE STE 280
Second Line	:
City	:	TURLOCK
State	:	CA
Zip	:	95382-2708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 COLORADO AVE STE 280
Second Line	:
City	:	TURLOCK
State	:	CA
Zip	:	95382-2708
Country	:	US
Telephone Number	:	209-277-0981
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. BRONEIL ISHAYA
Credential	:	DDS
Telephone Number	:	209-277-0981

Provider Enumeration Date	:	12/18/2025
Last Update Date	:	12/18/2025

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Directions to “ISHAYA DENTAL CORPORATION ” Practice Location

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