Healthcare Provider Details

I. General information

NPI: 1588527279
Provider Name (Legal Business Name): VRAJ GAJJAR DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 N BOYLAN AVE
RALEIGH NC
27603-1422
US

IV. Provider business mailing address

2110 MAGGIE VALLEY DR
APEX NC
27502-7073
US

V. Phone/Fax

Practice location:
  • Phone: 919-828-3775
  • Fax:
Mailing address:
  • Phone: 757-679-5559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: VRAJ GAJJAR
Title or Position: OWNER
Credential: DDS
Phone: 757-679-5559