Healthcare Provider Details

I. General information

NPI: 1699296186
Provider Name (Legal Business Name): RAINISH DHUKA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 10/30/2023
Certification Date: 10/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10610 GASTON ROAD SUITE 120
KATY TX
77494
US

IV. Provider business mailing address

5026 SKIPPING STONE LN
SUGAR LAND TX
77479-1668
US

V. Phone/Fax

Practice location:
  • Phone: 821-371-6368
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number33092
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: