=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508723446
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAJURKAR DENTAL INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2026
-----------------------------------------------------
Last Update Date | 01/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7211 HAVEN AVE STE D
-----------------------------------------------------
City | RANCHO CUCAMONGA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91701-6014
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-256-8484
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 9224
-----------------------------------------------------
City | ALTA LOMA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91701-8224
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. SEJAL RAJURKAR
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 909-256-8484
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------