Provider Type Icon

DR. RAISON SUJAI BOSE DDS NPI 1780815928


NPI Information

NPI: 1780815928
Provider Name: DR. RAISON SUJAI BOSE, DDS
Classification: Dentist - 1223E0200X
Entity Type: Individual

Specialization: Endodontics

PECOS Registration: Yes

Address:
2600 N MAYFAIR RD
SUITE 240
WAUWATOSA, WI
ZIP 53226
Phone: (414) 258-1500
Get Directions

DR. Raison Sujai Bose, DDS is an endodontics dentist in Wauwatosa, WI. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. DR. Raison Sujai Bose, DDS NPI is 1780815928. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2600 N MAYFAIR RD
SUITE 240
WAUWATOSA, WI
ZIP 53226-309
Phone: (414) 258-1500
Fax: (414) 258-9353

The NPI 1780815928 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 8/6/2009 and was last updated on 4/18/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223E0200XDentistEndodontics6750-015WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1UTSA 887XOTHERTEXASTEXAS STATE BOARD OF DENTAL EXAMINERS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.