Provider Demographics
NPI:1922111087
Name:RANA, RAJENDRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAJENDRA
Middle Name:
Last Name:RANA
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 1:15 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3721
Mailing Address - Country:US
Mailing Address - Phone:845-338-2525
Mailing Address - Fax:845-338-0532
Practice Address - Street 1:15 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3721
Practice Address - Country:US
Practice Address - Phone:845-338-2525
Practice Address - Fax:845-338-0532
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0371561223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics