Provider Demographics
NPI:1649483819
Name:RAO, VIKRAM KUMAR (DDS)
Entity type:Individual
Prefix:DR
First Name:VIKRAM
Middle Name:KUMAR
Last Name:RAO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:VIK
Other - Middle Name:
Other - Last Name:RAO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:910 W PARKER RD
Mailing Address - Street 2:#200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075
Mailing Address - Country:US
Mailing Address - Phone:972-423-8555
Mailing Address - Fax:
Practice Address - Street 1:910 W PARKER RD
Practice Address - Street 2:#200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075
Practice Address - Country:US
Practice Address - Phone:972-423-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15819122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist