Provider Demographics
NPI:1689783367
Name:BEYER, RACHEL M (DDS)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:M
Last Name:BEYER
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 1:6780 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-4542
Mailing Address - Country:US
Mailing Address - Phone:225-922-9540
Mailing Address - Fax:225-926-2889
Practice Address - Street 1:6780 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4542
Practice Address - Country:US
Practice Address - Phone:225-922-9540
Practice Address - Fax:225-926-2889
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA56241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1754371OtherUNITED CONCORDIA
LA1856240Medicaid