Provider Demographics
NPI:1003481797
Name:BATTH, RAJDEEP (DDS)
Entity type:Individual
Prefix:DR
First Name:RAJDEEP
Middle Name:
Last Name:BATTH
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 1:1005 29TH AVE SE APT F
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2743
Mailing Address - Country:US
Mailing Address - Phone:213-547-0762
Mailing Address - Fax:
Practice Address - Street 1:1670 BEAM AVE STE 204
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1227
Practice Address - Country:US
Practice Address - Phone:651-925-8423
Practice Address - Fax:651-773-7568
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14525122300000X
PADS042938122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist