Provider Demographics
NPI:1053575183
Name:GARG, RAJIV (DDS)
Entity type:Individual
Prefix:
First Name:RAJIV
Middle Name:
Last Name:GARG
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 1:1284 E LATHAM AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4445
Mailing Address - Country:US
Mailing Address - Phone:951-929-0300
Mailing Address - Fax:951-929-0335
Practice Address - Street 1:1284 E LATHAM AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4445
Practice Address - Country:US
Practice Address - Phone:951-929-0300
Practice Address - Fax:951-929-0335
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA572231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice