Provider Demographics
NPI:1558690032
Name:DAMANI, RAJESH V (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:V
Last Name:DAMANI
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 1:17767 CALLE BARCELONA
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-4172
Mailing Address - Country:US
Mailing Address - Phone:626-849-8557
Mailing Address - Fax:
Practice Address - Street 1:279 S ATLANTIC BLVD # B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1734
Practice Address - Country:US
Practice Address - Phone:323-266-0899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-13
Last Update Date:2009-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28674122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist