Provider Demographics
NPI:1285287011
Name:NGAI, RACHEL (DMD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:NGAI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13208 MYFORD RD APT 341
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-9113
Mailing Address - Country:US
Mailing Address - Phone:646-552-6942
Mailing Address - Fax:
Practice Address - Street 1:29950 HAUN RD STE 302
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92586-6527
Practice Address - Country:US
Practice Address - Phone:951-679-1667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-21
Last Update Date:2019-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1040241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty