Provider Demographics
NPI:1427131010
Name:BIJOOR, RENUKA RAO (DDS MPH MDS FDSRCS)
Entity type:Individual
Prefix:DR
First Name:RENUKA
Middle Name:RAO
Last Name:BIJOOR
Suffix:
Gender:F
Credentials:DDS MPH MDS FDSRCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:325 S HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-2096
Mailing Address - Country:US
Mailing Address - Phone:914-762-4151
Mailing Address - Fax:914-762-4153
Practice Address - Street 1:325 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-2096
Practice Address - Country:US
Practice Address - Phone:914-762-4151
Practice Address - Fax:914-762-4153
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0511601223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry