Provider Demographics
NPI:1962784843
Name:RAI, VAIBHAV (DDS)
Entity type:Individual
Prefix:DR
First Name:VAIBHAV
Middle Name:
Last Name:RAI
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 1:7350 VAN DUSEN RD
Mailing Address - Street 2:SUIT 440
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5263
Mailing Address - Country:US
Mailing Address - Phone:301-725-0131
Mailing Address - Fax:301-725-0132
Practice Address - Street 1:7350 VAN DUSEN RD
Practice Address - Street 2:440
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5263
Practice Address - Country:US
Practice Address - Phone:301-725-0131
Practice Address - Fax:301-725-0132
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD149821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice