Provider Demographics
NPI:1699256149
Name:RAINA DENTAL CARE PC
Entity type:Organization
Organization Name:RAINA DENTAL CARE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MANDEEP
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:RAINA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-381-4021
Mailing Address - Street 1:2323 NAPERVILLE RD.
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563
Mailing Address - Country:US
Mailing Address - Phone:630-381-4021
Mailing Address - Fax:
Practice Address - Street 1:2323 NAPERVILLE RD.
Practice Address - Street 2:SUITE 110
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563
Practice Address - Country:US
Practice Address - Phone:630-381-4021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019026208122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty