Provider Demographics
NPI:1932541687
Name:RASTOGI, LOVEENA (DDS)
Entity Type:Individual
Prefix:
First Name:LOVEENA
Middle Name:
Last Name:RASTOGI
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 1:7768 OZARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-5891
Mailing Address - Country:US
Mailing Address - Phone:904-442-6000
Mailing Address - Fax:
Practice Address - Street 1:7768 OZARK DR STE 200
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-5891
Practice Address - Country:US
Practice Address - Phone:757-827-5665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL274671223P0221X
VA04014141411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0221XDental ProvidersDentistPediatric Dentistry