Provider Demographics
NPI:1942420682
Name:VIBHAKAR, RASHMIKANT MOHANLAL (DDS)
Entity Type:Individual
Prefix:
First Name:RASHMIKANT
Middle Name:MOHANLAL
Last Name:VIBHAKAR
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 1:1381 RIVER OAK DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2949
Mailing Address - Country:US
Mailing Address - Phone:630-527-1104
Mailing Address - Fax:
Practice Address - Street 1:300 N OTTAWA ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-4009
Practice Address - Country:US
Practice Address - Phone:815-726-9301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist