Provider Demographics
NPI:1821299058
Name:NANDA, RAJAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAJAN
Middle Name:
Last Name:NANDA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ROGER
Other - Middle Name:
Other - Last Name:NANDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:9402 HENDON LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-6024
Mailing Address - Country:US
Mailing Address - Phone:713-772-5656
Mailing Address - Fax:
Practice Address - Street 1:14535 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5428
Practice Address - Country:US
Practice Address - Phone:713-598-6365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX168621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice