=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720982440
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RSR DENTAL HOLDINGS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2026
-----------------------------------------------------
Last Update Date | 10/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2885 HAMILTON BLVD SUITE A4
-----------------------------------------------------
City | SOUTH PLAINFIELD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07080
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-910-3882
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3402 JORDAN DR
-----------------------------------------------------
City | PRINCETON JUNCTION
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08550-1858
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-910-3882
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PEDIATRIC DENTIST
-----------------------------------------------------
Name | KHUSHALI RAM
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 732-910-3882
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------