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NPI Code Detail

MEDICARE: DR. RISHI RAJ KHANNA D.M.D

MEDICARE: DR. RISHI RAJ KHANNA D.M.D
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
11223G0001XGeneral Practice Dentistry24730TX

General Provider Information

NPI Number : 1134323587
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RISHI RAJ KHANNA D.M.D
Provider Business Mailing Address
First Line : 4645 SWEETWATER BLVD STE 300
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-3016
Country : US
Telephone Number : 857-540-1642
Fax Number :
Provider Business Practice Location Address
First Line : 4645 SWEETWATER BLVD STE 300
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-3016
Country : US
Telephone Number : 857-540-1642
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2007
Last Update Date : 07/14/2014

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