Provider Demographics
NPI:1023143229
Name:OBEROI, RAVI CHANDER (DMD)
Entity type:Individual
Prefix:
First Name:RAVI
Middle Name:CHANDER
Last Name:OBEROI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 TURKEY LAKE RD
Mailing Address - Street 2:SUITE 1-9
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-4707
Mailing Address - Country:US
Mailing Address - Phone:407-352-7700
Mailing Address - Fax:407-352-7787
Practice Address - Street 1:6900 TURKEY LAKE RD
Practice Address - Street 2:SUITE 1-9
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4707
Practice Address - Country:US
Practice Address - Phone:407-352-7700
Practice Address - Fax:407-352-7787
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14640122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL075994500Medicaid