Healthcare Provider Details

I. General information

NPI: 1144005141
Provider Name (Legal Business Name): RAJ UKANI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7380 CLAIREMONT MESA BLVD STE 100
SAN DIEGO CA
92111-1116
US

IV. Provider business mailing address

7380 CLAIREMONT MESA BLVD STE 100
SAN DIEGO CA
92111-1116
US

V. Phone/Fax

Practice location:
  • Phone: 858-715-8080
  • Fax:
Mailing address:
  • Phone: 858-715-8080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number109151
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: