Provider Demographics
NPI:1083266225
Name:BYLAND, RACHEL N (DMD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:N
Last Name:BYLAND
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:N
Other - Last Name:HEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-1841
Mailing Address - Country:US
Mailing Address - Phone:479-437-3449
Mailing Address - Fax:479-243-0285
Practice Address - Street 1:1723 MALVERN AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7133
Practice Address - Country:US
Practice Address - Phone:888-710-8220
Practice Address - Fax:866-573-0761
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2023-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR43561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR236364608Medicaid