Provider Demographics
NPI:1356983001
Name:RAKSHA BARNES DMD LLC
Entity type:Organization
Organization Name:RAKSHA BARNES DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAKSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:443-708-0663
Mailing Address - Street 1:838 S CONKLING ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4303
Mailing Address - Country:US
Mailing Address - Phone:443-708-0663
Mailing Address - Fax:
Practice Address - Street 1:838 S CONKLING ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4303
Practice Address - Country:US
Practice Address - Phone:443-708-0663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental