Provider Demographics
NPI:1104606581
Name:GHAI, RICKY KUMAR
Entity type:Individual
Prefix:
First Name:RICKY
Middle Name:KUMAR
Last Name:GHAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2442 SW CARY PKWY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-5318
Mailing Address - Country:US
Mailing Address - Phone:919-674-6070
Mailing Address - Fax:
Practice Address - Street 1:2442 SW CARY PKWY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-5318
Practice Address - Country:US
Practice Address - Phone:919-674-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC134641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice