MEDICARE: DR. ROOPA GULATI-RAO MS, 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	13986	MD
2	122300000X	Dentist	048952	NY
3	122300000X	Dentist	0401412594	VA
4	122300000X	Dentist	DEN1000824	DC

General Provider Information

NPI Number	:	1881879385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROOPA GULATI-RAO MS, DDS

Provider Business Mailing Address
First Line	:	605 GARDEN VIEW SQ
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-6116
Country	:	US
Telephone Number	:	240-477-6583
Fax Number	:

Provider Business Practice Location Address
First Line	:	20400 OBSERVATION DR
Second Line	:	SUITE 208
City	:	GERMANTOWN
State	:	MD
Zip	:	20876-4085
Country	:	US
Telephone Number	:	301-528-8685
Fax Number	:

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

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	09/17/2009

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