Provider Demographics
NPI:1871711259
Name:PEMA, RAKESH DHIRU (DDS)
Entity type:Individual
Prefix:DR
First Name:RAKESH
Middle Name:DHIRU
Last Name:PEMA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 N POWER RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-9509
Mailing Address - Country:US
Mailing Address - Phone:480-832-9199
Mailing Address - Fax:480-832-5030
Practice Address - Street 1:1909 N POWER RD
Practice Address - Street 2:SUITE 103
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-9509
Practice Address - Country:US
Practice Address - Phone:480-832-9199
Practice Address - Fax:480-832-5030
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD65451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice