Provider Demographics
NPI:1265040984
Name:RAJAN, MOIZZA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MOIZZA
Middle Name:
Last Name:RAJAN
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 1:553 SHORTHORN WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4510
Mailing Address - Country:US
Mailing Address - Phone:443-949-2887
Mailing Address - Fax:
Practice Address - Street 1:780 GOVERNOR RITCHIE HWY STE 30
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4135
Practice Address - Country:US
Practice Address - Phone:410-384-9030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD169961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice