Provider Demographics
NPI:1104955897
Name:RAJANI, ANJALI KRISHNAKUMAR (DDS)
Entity type:Individual
Prefix:
First Name:ANJALI
Middle Name:KRISHNAKUMAR
Last Name:RAJANI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82969
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33682-2969
Mailing Address - Country:US
Mailing Address - Phone:813-866-0950
Mailing Address - Fax:813-866-0929
Practice Address - Street 1:1502 E FOWLER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-5416
Practice Address - Country:US
Practice Address - Phone:813-866-0950
Practice Address - Fax:813-866-0929
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHAD61223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry