Healthcare Provider Details

I. General information

NPI: 1801093976
Provider Name (Legal Business Name): RAJESH BALCHANDANI, D.D.S. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2007
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19501 DOCTORS DR
GERMANTOWN MD
20874-5247
US

IV. Provider business mailing address

19501 DOCTORS DR
GERMANTOWN MD
20874-5247
US

V. Phone/Fax

Practice location:
  • Phone: 301-528-2600
  • Fax: 301-528-6688
Mailing address:
  • Phone: 301-528-2600
  • Fax: 301-528-6688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number12920
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number13432
License Number StateMD

VIII. Authorized Official

Name: DR. RAJESH BALCHANDANI
Title or Position: OWNER
Credential: D.D.S.
Phone: 301-528-2600