Provider Demographics
NPI:1780050948
Name:RAJAN, RESHMA (DDS)
Entity type:Individual
Prefix:DR
First Name:RESHMA
Middle Name:
Last Name:RAJAN
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 1:17 DARTMOUTH AVE APT 4B
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3425
Mailing Address - Country:US
Mailing Address - Phone:908-635-1669
Mailing Address - Fax:
Practice Address - Street 1:360 CONNECTICUT AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-1824
Practice Address - Country:US
Practice Address - Phone:203-831-0080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-11
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0114751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice