Provider Demographics
NPI:1124293543
Name:RAHMAN, RAFEEQ NAINA (DDS)
Entity type:Individual
Prefix:DR
First Name:RAFEEQ
Middle Name:NAINA
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 E CALIFORNIA BLVD
Mailing Address - Street 2:APT 105
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-3689
Mailing Address - Country:US
Mailing Address - Phone:718-404-6128
Mailing Address - Fax:
Practice Address - Street 1:1761 W ROMNEYA DR STE J
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1816
Practice Address - Country:US
Practice Address - Phone:714-635-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-26
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA558091223G0001X
ORD91541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice