Provider Demographics
NPI:1750443859
Name:JAIN, RASIKA (DDS)
Entity Type:Individual
Prefix:DR
First Name:RASIKA
Middle Name:
Last Name:JAIN
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 1:630 NORDAHL RD STE D
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-3541
Mailing Address - Country:US
Mailing Address - Phone:760-480-1750
Mailing Address - Fax:760-480-1336
Practice Address - Street 1:630 NORDAHL RD STE D
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-3541
Practice Address - Country:US
Practice Address - Phone:760-480-1750
Practice Address - Fax:760-480-1336
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA423321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice