MEDICARE: DR. RAJESWARI SANKARANARAYANAN DMD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	122300000X	Dentist	40548	TX

General Provider Information

NPI Number	:	1407695711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAJESWARI SANKARANARAYANAN DMD

Provider Business Mailing Address
First Line	:	5005 GALLERIA APT 2120
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5333
Country	:	US
Telephone Number	:	610-757-5792
Fax Number	:

Provider Business Practice Location Address
First Line	:	5005 GALLERIA
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5331
Country	:	US
Telephone Number	:	610-757-5792
Fax Number	:

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

Provider Enumeration Date	:	05/24/2024
Last Update Date	:	07/29/2024

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