Provider Demographics
NPI:1275721649
Name:RAJBANSHI, RANJAN
Entity Type:Individual
Prefix:DR
First Name:RANJAN
Middle Name:
Last Name:RAJBANSHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13061 ROSEDALE HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-7612
Mailing Address - Country:US
Mailing Address - Phone:661-588-5511
Mailing Address - Fax:661-588-5522
Practice Address - Street 1:13061 ROSEDALE HWY
Practice Address - Street 2:SUITE B
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93314-7612
Practice Address - Country:US
Practice Address - Phone:661-588-5511
Practice Address - Fax:661-588-5522
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55653122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD55653Medicaid