Prabha R Raju, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15924 Issued in MI

Practice address

1024 N Genesee Rd
Burton, MI 48509-1433

Phone

(810) 715-3368

Fax

(810) 715-1663

NPI assigned

Apr 9, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Oral Surgery

Education

Other, 1990

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tender Dental Care PC

  • General Practice Dentistry
  • Burton, MI
  • NPI 1073689899
  Medicare reassignment Authorized official
• Tender Dental Care

  • Dentist
  • Burton, MI
  • NPI 1871009829
  NPD Authorized official

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1710150925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 N GENESEE RD",
            "address_2": "P O BOX 90161",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091433",
            "telephone_number": "810-715-3368",
            "fax_number": "810-715-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 N GENESEE RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091433",
            "telephone_number": "810-715-3368",
            "fax_number": "810-715-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJU",
        "first_name": "PRABHA",
        "middle_name": "R",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "15924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quality Dental Services of Michigan, PC
• Quest Health Systems VI PLLC (HealthQuest of Burton)
• Emily Rader
• Nazia Rahman
• Furqan Rajput, MD
• Munroop Randhawa, MD
• Arash Raoofi, R.PH.
• Ryan Kenneth Rawlings, DDS
• Tamiah Redwine
• Blanca Marie Reiber

• General Practice Dentistry in Burton, MI
• Providers in Burton, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.