Provider Demographics
NPI:1831486380
Name:RANA, DEEPT (DDS)
Entity type:Individual
Prefix:DR
First Name:DEEPT
Middle Name:
Last Name:RANA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11178 DITCH RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-9548
Mailing Address - Country:US
Mailing Address - Phone:734-369-7375
Mailing Address - Fax:
Practice Address - Street 1:3611 W 16TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-2501
Practice Address - Country:US
Practice Address - Phone:734-369-7375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012266A122300000X
IL0190287261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice