Provider Demographics
NPI:1518373232
Name:ROSEN, RACHEL (DDS)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:ROSEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9964 VAIL DR
Mailing Address - Street 2:#1
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-2972
Mailing Address - Country:US
Mailing Address - Phone:330-425-1885
Mailing Address - Fax:
Practice Address - Street 1:9964 VAIL DR
Practice Address - Street 2:#1
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-2972
Practice Address - Country:US
Practice Address - Phone:330-425-1885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0242321223G0001X
OH30.0242321223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice