Provider Demographics
NPI:1194039362
Name:RAO, LOKESH C (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOKESH
Middle Name:C
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 1:171 E 89TH ST
Mailing Address - Street 2:7H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-2381
Mailing Address - Country:US
Mailing Address - Phone:646-530-4722
Mailing Address - Fax:914-961-1799
Practice Address - Street 1:1925 CENTRAL PARK AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-2949
Practice Address - Country:US
Practice Address - Phone:914-961-1700
Practice Address - Fax:914-961-1799
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054821122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice