Provider Demographics
NPI:1235547605
Name:JHA, RACHANA (DDS)
Entity Type:Individual
Prefix:
First Name:RACHANA
Middle Name:
Last Name:JHA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 OLD DOWLEN RD
Mailing Address - Street 2:921
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-6620
Mailing Address - Country:US
Mailing Address - Phone:817-914-3795
Mailing Address - Fax:
Practice Address - Street 1:681 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657-7378
Practice Address - Country:US
Practice Address - Phone:817-914-3795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30354122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist