Provider Demographics
NPI:1477887750
Name:CHAKRABORTY, RAJASHREE (DDS)
Entity Type:Individual
Prefix:
First Name:RAJASHREE
Middle Name:
Last Name:CHAKRABORTY
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 1:401 COMMERCE DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:FT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2714
Mailing Address - Country:US
Mailing Address - Phone:267-460-4254
Mailing Address - Fax:215-646-6166
Practice Address - Street 1:1950 STREET RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-3755
Practice Address - Country:US
Practice Address - Phone:215-638-4696
Practice Address - Fax:215-638-7452
Is Sole Proprietor?:No
Enumeration Date:2009-09-20
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DIO24213001223G0001X
PADS0381121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice