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General NPI Number Information
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NPI Number | 1669600771
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Entity Type | Individual
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Provider Name | PRITI RANA MAHAJAN DMD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2009
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Last Update Date | 05/02/2017
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Provider Practice Location Address
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Address Line | 4222 KATTMAN CT
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City | CARMEL
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State | IN
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Zip | 46074-1108
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Country | US
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Telephone | 317-797-6688
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Fax |
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Provider Business Mailing Address
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Address Line | 4222 KATTMAN CT
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City | CARMEL
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State | IN
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Zip | 46074-1108
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Country | US
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Telephone | 317-797-6688
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12011584A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 12011584A
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License Number State | IN
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