MEDICARE: DR. RAMESH DAVID RAO DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DE00009387	WA

General Provider Information

NPI Number	:	1174747422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMESH DAVID RAO DDS

Provider Business Mailing Address
First Line	:	3540 LAKE WASHINGTON BLVD SE APT 211
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98006-1159
Country	:	US
Telephone Number	:	425-221-0228
Fax Number	:

Provider Business Practice Location Address
First Line	:	3540 LAKE WASHINGTON BLVD SE APT 211
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98006-1159
Country	:	US
Telephone Number	:	425-221-0228
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	07/08/2007

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