Provider Demographics
NPI:1922217447
Name:RAO, RITU M (DDS)
Entity Type:Individual
Prefix:DR
First Name:RITU
Middle Name:M
Last Name:RAO
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 1:4145 BELT LINE RD STE 208
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4378
Mailing Address - Country:US
Mailing Address - Phone:972-233-0973
Mailing Address - Fax:
Practice Address - Street 1:4145 BELT LINE RD STE 208
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4378
Practice Address - Country:US
Practice Address - Phone:972-233-0973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21326122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist