Provider Demographics
NPI:1144732157
Name:LUTHRA, RAKHI (DDS)
Entity type:Individual
Prefix:DR
First Name:RAKHI
Middle Name:
Last Name:LUTHRA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2258 PLUMGROVE LN
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1465
Mailing Address - Country:US
Mailing Address - Phone:734-757-0788
Mailing Address - Fax:
Practice Address - Street 1:41069 DEQUINDRE RD STE 101
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-6730
Practice Address - Country:US
Practice Address - Phone:248-266-3175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901022464122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist