Provider Demographics
NPI:1184004020
Name:RAJAN SHARMA DDS MSD PC
Entity Type:Organization
Organization Name:RAJAN SHARMA DDS MSD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MSD
Authorized Official - Phone:630-960-4447
Mailing Address - Street 1:5215 OLD ORCHARD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1035
Mailing Address - Country:US
Mailing Address - Phone:847-663-0400
Mailing Address - Fax:
Practice Address - Street 1:5215 OLD ORCHARD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1035
Practice Address - Country:US
Practice Address - Phone:847-663-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0210015691223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty