Provider Demographics
NPI:1114920113
Name:RAO, SANJAY V (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:V
Last Name:RAO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 W SPRING CREEK PKWY STE 704
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5278
Mailing Address - Country:US
Mailing Address - Phone:972-596-3300
Mailing Address - Fax:972-559-3748
Practice Address - Street 1:4105 W SPRING CREEK PKWY STE 704
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5278
Practice Address - Country:US
Practice Address - Phone:972-596-3300
Practice Address - Fax:972-559-3748
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX187571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice