Provider Demographics
NPI:1346340783
Name:REHM, SCOTT R (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:REHM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405
Mailing Address - Country:US
Mailing Address - Phone:336-621-1554
Mailing Address - Fax:336-621-3402
Practice Address - Street 1:2708 HENRY ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405
Practice Address - Country:US
Practice Address - Phone:336-621-1554
Practice Address - Fax:336-621-3402
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC55251223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8997294Medicaid
NC02635OtherBCBS
U29004Medicare UPIN
NC2345053Medicare ID - Type Unspecified