MEDICARE: SAROJINI K. RAMBHATLA D.D.S., INC.

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	35318	CA

General Provider Information

NPI Number	:	1295861706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAROJINI K. RAMBHATLA D.D.S., INC.

Provider Business Mailing Address
First Line	:	PO BOX 90456
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91109-0456
Country	:	US
Telephone Number	:	626-449-3700
Fax Number	:	626-449-8351

Provider Business Practice Location Address
First Line	:	929 N ORANGE GROVE BLVD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91103-3354
Country	:	US
Telephone Number	:	626-449-3700
Fax Number	:	626-449-8351

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SAROJINI K RAMBHATLA
Credential	:	D.D.S.
Telephone Number	:	626-449-3700

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	08/22/2020

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