Provider Demographics
NPI:1053439539
Name:RALLI, LING ELENA (DDS)
Entity type:Individual
Prefix:DR
First Name:LING
Middle Name:ELENA
Last Name:RALLI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LING
Other - Middle Name:ELENA
Other - Last Name:XIAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:7456 FOOTHILLS BLVD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-6560
Mailing Address - Country:US
Mailing Address - Phone:916-773-0800
Mailing Address - Fax:916-773-0835
Practice Address - Street 1:7456 FOOTHILLS BLVD
Practice Address - Street 2:SUITE 14
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-6560
Practice Address - Country:US
Practice Address - Phone:916-773-0800
Practice Address - Fax:916-773-0835
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA478281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice