Provider Demographics
NPI:1215388061
Name:RAO, AARATHI RAVISH (MDS DDS)
Entity Type:Individual
Prefix:DR
First Name:AARATHI
Middle Name:RAVISH
Last Name:RAO
Suffix:
Gender:F
Credentials:MDS DDS
Other - Prefix:
Other - First Name:AARATHI
Other - Middle Name:
Other - Last Name:S
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:GREATER ATLANTA ORAL FACIAL SURGERY
Mailing Address - Street 2:425 PEACHTREE PARKWAY SUITE 340
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041
Mailing Address - Country:US
Mailing Address - Phone:972-757-2905
Mailing Address - Fax:
Practice Address - Street 1:GREATER ATLANTA ORAL FACIAL SURGERY
Practice Address - Street 2:425 PEACHTREE PARKWAY SUITE 340
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041
Practice Address - Country:US
Practice Address - Phone:404-476-3667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1232361223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MND13704Medicaid