Individual provider Active NPI

Rasool Maan

  • Dentist
  • Stockton, CA
National Provider Identifier
1528633286
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
111569 Issued in CA
Practice address
3453 Brookside Rd Ste a
Stockton, CA 95219-1788
Phone
(209) 955-1500
NPI assigned
May 25, 2021
Last updated
Oct 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 111569 CA Primary
Dentist 122300000X 7632 NV

Addresses

Primary practice location

3453 Brookside Rd Ste a
Stockton, CA 95219-1788

Mailing address

4022 Sunrise Blvd Ste 120-131
Rancho Cordova, CA 95742-6911
Phone (925) 699-2094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919003264 NV Order and Referring Only - DentistPractitioner - Dentist 2264817717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Maan Dental Corporation Past Accepting new patients
Image Dental Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1528633286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 SUNRISE BLVD STE 120-131",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "957426911",
            "telephone_number": "925-699-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3453 BROOKSIDE RD STE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952191788",
            "telephone_number": "209-955-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAAN",
        "first_name": "RASOOL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "111569",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "7632",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.