MEDICARE: RAKHI RAO DDS

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	122300000X	Dentist	23235	TX

General Provider Information

NPI Number	:	1790979847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAKHI RAO DDS

Provider Business Mailing Address
First Line	:	1625 S BELT LINE RD STE 100
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75051-3302
Country	:	US
Telephone Number	:	972-282-9100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1625 S BELT LINE RD STE 100
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75051-3302
Country	:	US
Telephone Number	:	972-282-9100
Fax Number	:

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

Provider Enumeration Date	:	08/31/2007
Last Update Date	:	08/26/2013

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