Provider Demographics
NPI:1730897695
Name:RANI SHINA, D.D.S., INC
Entity type:Organization
Organization Name:RANI SHINA, D.D.S., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING LEAD
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA-ROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-869-3789
Mailing Address - Street 1:12285 SCRIPPS POWAY PARKWAY SUITE 104
Mailing Address - Street 2:
Mailing Address - City:POWATY
Mailing Address - State:CA
Mailing Address - Zip Code:92604
Mailing Address - Country:US
Mailing Address - Phone:858-536-8111
Mailing Address - Fax:
Practice Address - Street 1:12285 SCRIPPS POWAY PARKWAY SUITE 104
Practice Address - Street 2:
Practice Address - City:POWATY
Practice Address - State:CA
Practice Address - Zip Code:92604
Practice Address - Country:US
Practice Address - Phone:858-536-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty