Provider Demographics
NPI:1598841082
Name:VIJ, RAJESH (BDS DDS)
Entity Type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:
Last Name:VIJ
Suffix:
Gender:M
Credentials:BDS DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3523 COMMERCIAL DR
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-5107
Mailing Address - Country:US
Mailing Address - Phone:330-668-9977
Mailing Address - Fax:
Practice Address - Street 1:3523 COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-5107
Practice Address - Country:US
Practice Address - Phone:330-668-9977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH195981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0870900Medicaid