Healthcare Provider Details

I. General information

NPI: 1235298472
Provider Name (Legal Business Name): RANTI ARYANI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3930 KNOWLES AVE #300
KENSINGTON MD
20895
US

IV. Provider business mailing address

3930 KNOWLES AVE #300
KENSINGTON MD
20895
US

V. Phone/Fax

Practice location:
  • Phone: 240-550-1442
  • Fax: 484-930-0058
Mailing address:
  • Phone: 240-550-1442
  • Fax: 484-930-0058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS035903
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number16155
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN 16627
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS 035903
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: