Provider Demographics
NPI:1083840680
Name:TAYAL, AARTI (DDS)
Entity type:Individual
Prefix:DR
First Name:AARTI
Middle Name:
Last Name:TAYAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9260 ALCOSTA BLVD STE A7
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4132
Mailing Address - Country:US
Mailing Address - Phone:201-936-4538
Mailing Address - Fax:
Practice Address - Street 1:9260 ALCOSTA BLVD STE A7
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4132
Practice Address - Country:US
Practice Address - Phone:925-829-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63399122300000X, 1223G0001X
CT0100011223G0001X
NJ22DI024033001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008013979Medicaid