Provider Demographics
NPI:1942595459
Name:CHAUDHARI, REKHA R (DDS)
Entity Type:Individual
Prefix:DR
First Name:REKHA
Middle Name:R
Last Name:CHAUDHARI
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 1:4930 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-1959
Mailing Address - Country:US
Mailing Address - Phone:847-894-0631
Mailing Address - Fax:
Practice Address - Street 1:10409 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-2633
Practice Address - Country:US
Practice Address - Phone:317-399-5771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29654122300000X
IN12011643A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist