Provider Demographics
NPI:1518372861
Name:MANN, RACHEL RENEE (DDS)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:RENEE
Last Name:MANN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:RENEE
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:4220 RODNEY PARHAM RD SUITE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212
Mailing Address - Country:US
Mailing Address - Phone:501-351-1757
Mailing Address - Fax:
Practice Address - Street 1:4220 RODNEY PARHAM RD SUITE 200
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212
Practice Address - Country:US
Practice Address - Phone:501-954-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR39961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice