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NPI Code Detail

MEDICARE: RAJ VIJ DDS INC

MEDICARE: RAJ VIJ DDS 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
1261QD0000XDental Clinic/Center19598OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790169779
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAJ VIJ DDS INC
Provider Business Mailing Address
First Line : 3523 COMMERCIAL DR
Second Line :
City : FAIRLAWN
State : OH
Zip : 44333-5107
Country : US
Telephone Number : 330-668-9977
Fax Number :
Provider Business Practice Location Address
First Line : 3523 COMMERCIAL DR
Second Line :
City : FAIRLAWN
State : OH
Zip : 44333-5107
Country : US
Telephone Number : 330-668-9977
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. RAJESH VIJ
Credential : DDS
Telephone Number : 330-668-9977
Provider Enumeration Date : 07/19/2015
Last Update Date : 07/19/2015

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