Provider Demographics
NPI:1982873964
Name:RAINA, RAKESH (DDS,)
Entity Type:Individual
Prefix:
First Name:RAKESH
Middle Name:
Last Name:RAINA
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 1:1815 SATELLITE BLVD
Mailing Address - Street 2:SUITE # 301
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5237
Mailing Address - Country:US
Mailing Address - Phone:678-205-1028
Mailing Address - Fax:678-205-1030
Practice Address - Street 1:1815 SATELLITE BLVD
Practice Address - Street 2:SUITE # 301
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-5237
Practice Address - Country:US
Practice Address - Phone:678-205-1028
Practice Address - Fax:678-205-1030
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0117431223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics