Individual provider Active NPI

Roli Rajvanshi, D.D.S.

  • Dentist
  • Palmdale, CA
National Provider Identifier
1467869370
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63622 Issued in CA
Practice address
510 W Rancho Vista Blvd
Palmdale, CA 93551-3737
Phone
(661) 202-3052
NPI assigned
Jul 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63622 CA Primary

Addresses

Primary practice location

510 W Rancho Vista Blvd
Palmdale, CA 93551-3737

Mailing address

1119 W 29TH St
Apt#5
Los Angeles, CA 90007-3174
Phone (213) 447-9448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151110001225 CA Order and Referring Only - DentistPractitioner - Dentist 5890005524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63622CAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1467869370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 W 29TH ST",
            "address_2": "APT#5",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073174",
            "telephone_number": "213-447-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 W RANCHO VISTA BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513737",
            "telephone_number": "661-202-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJVANSHI",
        "first_name": "ROLI",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.