Provider Demographics
NPI:1699037507
Name:SAXENA, ADITI RAJESH (DDS)
Entity type:Individual
Prefix:DR
First Name:ADITI
Middle Name:RAJESH
Last Name:SAXENA
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 1:5610 E CENTRAL TEXAS EXPY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76543-5519
Mailing Address - Country:US
Mailing Address - Phone:254-680-4450
Mailing Address - Fax:
Practice Address - Street 1:5610 E CENTRAL TEXAS EXPY
Practice Address - Street 2:SUITE 3
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-5519
Practice Address - Country:US
Practice Address - Phone:254-680-4450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30873122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral Practice