Provider Demographics
NPI:1558566836
Name:RACHEL PERENITS DDS PA
Entity Type:Organization
Organization Name:RACHEL PERENITS DDS PA
Other - Org Name:ATLANTIS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:WEST
Authorized Official - Last Name:PERENTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-361-1998
Mailing Address - Street 1:1002 N CHURCH ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1439
Mailing Address - Country:US
Mailing Address - Phone:919-361-1998
Mailing Address - Fax:919-484-7432
Practice Address - Street 1:1002 N CHURCH ST
Practice Address - Street 2:SUITE 402
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1439
Practice Address - Country:US
Practice Address - Phone:919-361-1998
Practice Address - Fax:919-484-7432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7315122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014R6Medicaid