National Provider Identifier

Rahul Renjen, DDS

Rahul Renjen, DDS is listed in the NPPES registry with a primary specialty of Orthodontics and Dentofacial Orthopedics Dentistry in Ithaca, NY and a listed phone number of (716) 523-1885.

NPI 1376677633Ithaca, NYOrthodontics and Dentofacial Orthopedics Dentistry

Profile Overview

NPI
1376677633
Provider Type
Individual
Primary Specialty
Orthodontics and Dentofacial Orthopedics Dentistry
Enumeration Date
March 16, 2007
Last Updated
April 14, 2015

Practice Location

  • 103 White Park RD
  • Ithaca, NY 14850-2258

Phone: (716) 523-1885

Mailing Address

  • 2124 Penfield RD
  • Penfield, NY 14526-1736

Specialties

  • Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X)
  • Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X)
Full Record
NPI
1376677633
Entity Type
Individual
Last Name
Renjen
First Name
Rahul
Credential
DDS
Mailing Street Address
2124 Penfield RD
Mailing City
Penfield
Mailing State
NY
Mailing ZIP Code
14526-1736
Mailing Country
US
Mailing Phone
(585) 432-0455
Practice Street Address
103 White Park RD
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-2258
Practice Country
US
Practice Phone
(716) 523-1885
Enumeration Date
March 16, 2007
Last Updated
April 14, 2015
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X)
Other Identifiers
02898355 (NY), 1020266440001 (PA)