Provider Demographics
NPI:1629868229
Name:RAVINDER BOPARAI, DDS, P.C
Entity type:Organization
Organization Name:RAVINDER BOPARAI, DDS, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVINDER
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:BOPARAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-649-5434
Mailing Address - Street 1:3135 TALBOT DR
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:95330-9830
Mailing Address - Country:US
Mailing Address - Phone:347-649-5434
Mailing Address - Fax:
Practice Address - Street 1:1401 W 11TH ST STE A
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3702
Practice Address - Country:US
Practice Address - Phone:347-649-5434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty