Provider Demographics
NPI:1326295064
Name:VARARAJ, LLANELL (DDS, BDS)
Entity Type:Individual
Prefix:DR
First Name:LLANELL
Middle Name:
Last Name:VARARAJ
Suffix:
Gender:M
Credentials:DDS, BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:984 SANDRA CT
Mailing Address - Street 2:APT-2
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-2333
Mailing Address - Country:US
Mailing Address - Phone:415-571-8486
Mailing Address - Fax:415-571-8486
Practice Address - Street 1:984 SANDRA CT
Practice Address - Street 2:APT-2
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-2333
Practice Address - Country:US
Practice Address - Phone:415-571-8486
Practice Address - Fax:415-571-8486
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2010-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57422122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist