Provider Demographics
NPI:1326303140
Name:RAJAN, NITHYA HUNTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:NITHYA
Middle Name:HUNTER
Last Name:RAJAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16149 STATE ROUTE 104
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-9701
Mailing Address - Country:US
Mailing Address - Phone:740-774-7050
Mailing Address - Fax:
Practice Address - Street 1:16149 STATE ROUTE 104
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-9701
Practice Address - Country:US
Practice Address - Phone:740-774-7050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.023791122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist