Provider Demographics
NPI:1720469125
Name:NAGARAJAN, NAGARANI (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAGARANI
Middle Name:
Last Name:NAGARAJAN
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 1:1412 RIVENDELL WAY
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2019
Mailing Address - Country:US
Mailing Address - Phone:732-429-3794
Mailing Address - Fax:
Practice Address - Street 1:2510 VISTA DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-6253
Practice Address - Country:US
Practice Address - Phone:704-774-6001
Practice Address - Fax:704-558-6150
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10550122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist