Provider Demographics
NPI:1518685619
Name:OLIVIA RAUSCHENBACH DDS LLC
Entity Type:Organization
Organization Name:OLIVIA RAUSCHENBACH DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAUSCHENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-492-7822
Mailing Address - Street 1:200 WALNUT ST APT 304
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64106-1024
Mailing Address - Country:US
Mailing Address - Phone:605-351-7611
Mailing Address - Fax:
Practice Address - Street 1:10550 QUIVIRA RD STE 210
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2303
Practice Address - Country:US
Practice Address - Phone:913-492-7822
Practice Address - Fax:913-541-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty