Provider Demographics
NPI:1689563892
Name:TEMPLIN, RAYNI LEIGH (DDS)
Entity type:Individual
Prefix:
First Name:RAYNI
Middle Name:LEIGH
Last Name:TEMPLIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:RAYNI
Other - Middle Name:LEIGH
Other - Last Name:GULLETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9577 OAK VIEW CT NE
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-9140
Mailing Address - Country:US
Mailing Address - Phone:218-407-0004
Mailing Address - Fax:
Practice Address - Street 1:1405 ANNE ST NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-5113
Practice Address - Country:US
Practice Address - Phone:218-444-9646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND15346122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist