# LADERA RANCH MODERN DENTISTRY, PROF. CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ladera Ranch Modern Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114821014
- **Authorized official:** DEEPIKA DHAMA DDS (OWNER)
- **Authorized official phone:** (949) 354-5268

## Contact information

- **Practice address:** 27702 CROWN VALLEY PKWY STE A4, LADERA RANCH, CA 92694-0609
- **Practice address phone:** (949) 354-5268
- **Practice address fax:** (949) 347-5883
- **Mailing address:** PO BOX 660041, DALLAS, TX 75266-0041
- **Mailing address phone:** (714) 845-8890
- **Mailing address fax:** (303) 952-0892

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |

## Other

- **Enumeration date:** 10/05/2026
- **Last updated:** 10/05/2026