Provider Demographics
NPI:1851952394
Name:THESIYA, RONAK HANSRAJBHAI (DDS)
Entity type:Individual
Prefix:DR
First Name:RONAK
Middle Name:HANSRAJBHAI
Last Name:THESIYA
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 1:168 W RIDGE PIKE STE 300
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-3705
Mailing Address - Country:US
Mailing Address - Phone:215-450-0081
Mailing Address - Fax:
Practice Address - Street 1:168 W RIDGE PIKE STE 300
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-3705
Practice Address - Country:US
Practice Address - Phone:610-489-4495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35311122300000X
PADS042515122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty