Provider Demographics
NPI:1477696037
Name:RASI, RONALD C (DDS)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:C
Last Name:RASI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:568 N SUNRISE AVE STE 290
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3097
Mailing Address - Country:US
Mailing Address - Phone:916-782-7733
Mailing Address - Fax:916-782-7710
Practice Address - Street 1:568 N SUNRISE AVE STE 290
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3097
Practice Address - Country:US
Practice Address - Phone:916-782-7733
Practice Address - Fax:916-782-7710
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA451791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20-1878012OtherTAX ID#