Provider Demographics
NPI:1235360504
Name:RHEE, JOAN T (DDS)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:T
Last Name:RHEE
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 1:4044 MORSE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1448
Mailing Address - Country:US
Mailing Address - Phone:614-473-0400
Mailing Address - Fax:614-473-0200
Practice Address - Street 1:407 S. JAMES ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-1448
Practice Address - Country:US
Practice Address - Phone:614-236-1818
Practice Address - Fax:614-236-1060
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300230651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2955959Medicaid