Provider Demographics
NPI:1558127886
Name:CHAUDHRY, RAFIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAFIA
Middle Name:
Last Name:CHAUDHRY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 SOUTH DR STE 9
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4210
Mailing Address - Country:US
Mailing Address - Phone:650-967-1075
Mailing Address - Fax:
Practice Address - Street 1:505 SOUTH DR STE 9
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4210
Practice Address - Country:US
Practice Address - Phone:650-967-1075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA528371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice