DR. RAY DERAKSHAN (NPI# 1770621591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770621591 |
| Entity Type | Individual |
| Full Name | DR. RAY DERAKSHAN |
| Credential | D.M.D |
| Practice Address |
11134 Rancho Carmel Dr Suite 103 San Diego CA 92128-4671 |
| Practice Telephone | 8584851010 |
| Practice Fax Number | 8584851116 |
| Mailing Telephone | 8584851010 |
| Mailing Fax Number | 8584851116 |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
46044 | CA | Dental Providers |
| Street Address |
11134 RANCHO CARMEL DR SUITE 103 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92128-4671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306901301 | Pearle Visioncare, Inc | Eyewear Supplier (Equipment, not the service) | 11134 Rancho Carmel Dr, Courtyard Ste.#102, San Diego, CA 92128-4671 | 2006-12-27 |
| 1255579793 | Ray Derakshan, D.m.d. | Preferred Provider Organization | 11134 Rancho Carmel Dr, Suite #103, San Diego, CA 92128-4671 | 2009-01-21 |
| 1235381450 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 11134 Rancho Carmel Dr, Ste #102, San Diego, CA 92128-4671 | 2008-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585371 | Alicia Ford | Behavior Technician | 1170 Bernardo Plaza Court, Suite 350, San Diego, CA 92128 | 2020-07-08 |
| 1164087573 | Madeleine White | Dietitian, Registered | 16685 W Bernardo Dr, Suite 121, San Diego, CA 92128 | 2019-05-01 |
| 1053807677 | Joele Ghosn | Speech-Language Pathologist | 11838 Bernardo Plaza Ct #110, San Diego, CA 92128 | 2018-07-06 |
| 1376034348 | Eddie Reginald Burston II | In Home Supportive Care | 12727 Camino Emparrado, San Diego, CA 92128 | 2018-05-24 |
| 1336659218 | Ryan Fong | Physician Assistant | 15004 Innovation Drive (s97), San Diego, CA 92128 | 2017-10-05 |
| 1508316191 | Araceli Flores | Behavioral Analyst | 15737 Innovation Dr, Suite 200, San Diego, CA 92128 | 2016-10-07 |
| 1003283961 | Katherine Dishner | Hearing Instrument Specialist | 16766 Bernardo Center Dr Ste 206, San Diego, CA 92128 | 2015-08-27 |
| 1205212586 | Mobilia Dmd Inc. | Point of Service | 12405 Rancho Bernardo Rd., San Diego, CA 92128 | 2015-08-10 |
| 1346623634 | Angela Christine Storck-petersen | Dietitian, Registered | 11768 Caminito Corriente, San Diego, CA 92128 | 2015-07-04 |
| 1134526874 | Breeana Rose Lancaster | Speech-Language Pathologist | 11838 Bernardo Plaza Ct. Suite 110, Kids Therapy Associates, San Diego, CA 92128 | 2014-11-24 |
| Find all providers in zip 92128 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455181 | Julia Nguyen | Dentist | 9225 Mira Mesa Blvd Ste 218, San Diego, CA 92126-4811 | 2020-10-22 |
| 1831797489 | Lily Neskin | Dentist | 4454 Shorepointe Way, San Diego, CA 92130-8635 | 2020-10-15 |
| 1487251294 | Zeki Abdulaali | Dentist | 1501 India St Unit 607, San Diego, CA 92101-2449 | 2020-10-05 |
| 1629681895 | Elizabeth Rodriguez | Dentist | 14701 Via Bettona Ste 215, San Diego, CA 92127-4808 | 2020-08-27 |
| 1679183602 | Hayat Fahliogullari-smith | Dentist | 1281 9th Ave Unit 1309, San Diego, CA 92101-4655 | 2020-08-04 |
| 1235768631 | Virgnia Padua Mattson D.m.d. | Dentist | 11717 Bernardo Plaza Ct Ste 100, San Diego, CA 92128-2419 | 2020-04-07 |
| 1154956050 | Enbara Corporation | Dentist | 5189 Clairmont Mesa Blvd, San Diego, CA 92117 | 2020-03-11 |
| 1215568043 | Hage Dental Corporation | Dentist | 3365 Rosecrans St Ste C, San Diego, CA 92110-4256 | 2020-01-30 |
| 1275174310 | Yige Zhao Dental Corporation | Dentist | 9840 Carmel Mountain Rd, San Diego, CA 92129-2812 | 2019-09-30 |
| 1083255111 | Wayne David Gonzales | Dentist | 8031 Linda Vista Rd # 210, San Diego, CA 92111-5110 | 2019-09-30 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on DR. RAY DERAKSHAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.