Provider Demographics
NPI:1679307524
Name:DHOLAKIYA, HIRAL
Entity type:Individual
Prefix:
First Name:HIRAL
Middle Name:
Last Name:DHOLAKIYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5856 OWENS DR APT 303
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4830
Mailing Address - Country:US
Mailing Address - Phone:408-480-0337
Mailing Address - Fax:
Practice Address - Street 1:333 SAN CARLOS WAY
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-1956
Practice Address - Country:US
Practice Address - Phone:209-536-8333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110684122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist