Provider Demographics
NPI:1518690668
Name:RANSOM, REINA ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:REINA
Middle Name:ELIZABETH
Last Name:RANSOM
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 1:5840 FARRINGTON RD APT 318
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-8220
Mailing Address - Country:US
Mailing Address - Phone:248-410-6889
Mailing Address - Fax:
Practice Address - Street 1:215 CHARLES ROLLINS RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2883
Practice Address - Country:US
Practice Address - Phone:252-492-7563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC128071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12807OtherNC STATE LISENSE