1700341252 NPI number — RACHELL RICHMAN DDS PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700341252 NPI number — RACHELL RICHMAN DDS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RACHELL RICHMAN DDS PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1700341252
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1439
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OLATHE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81425-1439
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-323-6828
Provider Business Mailing Address Fax Number:
970-323-6186

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLATHE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-323-6828
Provider Business Practice Location Address Fax Number:
970-323-6828
Provider Enumeration Date:
02/08/2019

Additional Information

Authorized Official

Authorized Official Last Name:
RICHMAN
Authorized Official First Name:
RACHELL
Authorized Official Middle Name:
DAWN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
970-323-6828

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00203079 . This is a "LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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