1316969454 NPI number — DR. RACHEL J. MAJOR DDS

Table of content: DR. RACHEL J. MAJOR DDS (NPI 1316969454)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316969454 NPI number — DR. RACHEL J. MAJOR DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAJOR
Provider First Name:
RACHEL
Provider Middle Name:
J.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316969454
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20171 ICENIC TRAIL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKEVILLE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-469-3300
Provider Business Mailing Address Fax Number:
952-469-5655

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20171 ICENIC TRAIL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKEVILLE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-469-3300
Provider Business Practice Location Address Fax Number:
952-469-5655
Provider Enumeration Date:
07/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  D12161 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 978483 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 669127700 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1727 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 46092 DE . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 013454 . This is a "DORAL DENTAL" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com