Provider Demographics
NPI:1629584032
Name:RAKIAN, RUBIE A (DDS)
Entity Type:Individual
Prefix:
First Name:RUBIE
Middle Name:A
Last Name:RAKIAN
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 1:13631 ASCEND TER
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-1796
Mailing Address - Country:US
Mailing Address - Phone:305-389-4654
Mailing Address - Fax:
Practice Address - Street 1:13631 ASCEND TER
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-1796
Practice Address - Country:US
Practice Address - Phone:305-389-4654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX334941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice