Raj Darji, D.M.D
Individual provider Active NPI Dentist · Medford Lakes, NJ
NPI 1083074447 · NPPES record last updated Jun 3, 2023
Key facts
- NPI
- 1083074447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 22DI02673200 (NJ)
- Practice address
- 30 Jackson Rd Ste B1
Medford Lakes, NJ 08055-9280 - Phone
- (609) 953-0077
- NPI assigned
- Feb 28, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02673200 | NJ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sullivan Darji Dental | Dentist | Current |
Accepting new patients |
| Luna Smiles LLC | Current |
Accepting new patients |
Locations
30 Jackson Rd
Ste B1
Medford Lakes, NJ 08055
Phone (609) 953-0077
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 22DI02673200 | NJ | Yes |
Addresses
Primary practice location
30 Jackson Rd Ste B1
Medford Lakes, NJ 08055-9280
Mailing address
30 Jackson Rd Ste B1
Medford Lakes, NJ 08055-9280
Phone (609) 953-0077
Other providers in Medford Lakes, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.