MEDICARE: DR. SANJAY V. RAO D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	18757	TX

General Provider Information

NPI Number	:	1114920113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANJAY V. RAO D.D.S.

Provider Business Mailing Address
First Line	:	4105 W SPRING CREEK PKWY STE 704
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-5278
Country	:	US
Telephone Number	:	972-596-3300
Fax Number	:	972-559-3748

Provider Business Practice Location Address
First Line	:	4105 W SPRING CREEK PKWY STE 704
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-5278
Country	:	US
Telephone Number	:	972-596-3300
Fax Number	:	972-559-3748

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	12/01/2022

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