MEDICARE: SANJAY V 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	18757	TX

General Provider Information

NPI Number	:	1831396688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANJAY V RAO DDS

Provider Business Mailing Address
First Line	:	4105 W SPRING CREEK PKWY STE 704
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-5278
Country	:	US
Telephone Number	:	972-596-3300
Fax Number	:

Provider Business Practice Location Address
First Line	:	4105 W SPRING CREEK PKWY STE 704
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-5278
Country	:	US
Telephone Number	:	972-596-3300
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SANJAY V RAO
Credential	:	DDS
Telephone Number	:	972-596-3300

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	09/12/2007

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