Provider Demographics
NPI:1235294679
Name:NAYLOR, RACHEL HUBBARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:HUBBARD
Last Name:NAYLOR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 W MAPLE LEAF RD
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-9176
Mailing Address - Country:US
Mailing Address - Phone:606-564-9494
Mailing Address - Fax:606-564-9495
Practice Address - Street 1:399 W MAPLE LEAF RD
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-9176
Practice Address - Country:US
Practice Address - Phone:606-564-9494
Practice Address - Fax:606-564-9495
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY77631223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0438068003OtherTAX ID NUMBER
KY60002847Medicaid
KY1767839OtherUNITED CONCORDIA PROVIDER