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NPI Code Detail

MEDICARE: RAJAT DIWAN D.D.S.,

MEDICARE: RAJAT DIWAN 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
11223G0001XGeneral Practice Dentistry27926TX

General Provider Information

NPI Number : 1538467618
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAJAT DIWAN D.D.S.,
Provider Business Mailing Address
First Line : 2423 WILLIAMS DR STE 107
Second Line :
City : GEORGETOWN
State : TX
Zip : 78628-3269
Country : US
Telephone Number : 877-800-5722
Fax Number :
Provider Business Practice Location Address
First Line : 2411 WILLIAMS DR STE 111
Second Line :
City : GEORGETOWN
State : TX
Zip : 78628-3268
Country : US
Telephone Number : 877-800-5722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2011
Last Update Date : 06/30/2025

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