DR. RAY DERAKSHAN D.M.D NPI 1770621591

NPI Information

  • NPI: 1770621591
  • Provider Name: DR. RAY DERAKSHAN, D.M.D
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 11134 RANCHO CARMEL DR
    SUITE 103
    SAN DIEGO, CA
    ZIP 92128
  • Phone: (858) 485-1010

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NPI Details

DR. Ray Derakshan, D.M.D is a general practice dentist in San Diego, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Ray Derakshan, D.M.D NPI is 1770621591. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11134 RANCHO CARMEL DR
SUITE 103
SAN DIEGO, CA
ZIP 92128-671
Phone: (858) 485-1010
Fax: (858) 485-1116

The NPI 1770621591 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 2/2/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice46044CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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