Provider Demographics
NPI:1215388061
Name:RAO, AARATHI RAVISH (MDS DDS)
Entity type:Individual
Prefix:DR
First Name:AARATHI
Middle Name:RAVISH
Last Name:RAO
Suffix:
Gender:F
Credentials:MDS DDS
Other - Prefix:
Other - First Name:AARATHI
Other - Middle Name:
Other - Last Name:S
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:RIB MOUNTAIN ORAL SURGERY
Mailing Address - Street 2:4107, BARBICAN AVENUE, SUITE 200
Mailing Address - City:WESTON
Mailing Address - State:WI
Mailing Address - Zip Code:54476
Mailing Address - Country:US
Mailing Address - Phone:972-757-2905
Mailing Address - Fax:
Practice Address - Street 1:RIB MOUNTAIN ORAL SURGERY
Practice Address - Street 2:4107 BARBICAN AVENUE,STE 200
Practice Address - City:WESTON
Practice Address - State:WI
Practice Address - Zip Code:54476
Practice Address - Country:US
Practice Address - Phone:715-513-7667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1002252204E00000X
GADN1232361223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MND13704Medicaid