Provider Demographics
NPI:1558700369
Name:ROJAS, RAIKO (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAIKO
Middle Name:
Last Name:ROJAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7732 CAMINO REAL
Mailing Address - Street 2:APT 2A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7159
Mailing Address - Country:US
Mailing Address - Phone:786-278-0130
Mailing Address - Fax:
Practice Address - Street 1:1399 NW 17TH AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-2349
Practice Address - Country:US
Practice Address - Phone:305-325-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20138122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist