Provider Demographics
NPI:1790279636
Name:REZIN, BRITTANY ANN (DDS)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANN
Last Name:REZIN
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 1:401 CHURCH ST STE 2210
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-2204
Mailing Address - Country:US
Mailing Address - Phone:615-972-5871
Mailing Address - Fax:631-857-7860
Practice Address - Street 1:4301 STATE AVE BLDG A
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-3719
Practice Address - Country:US
Practice Address - Phone:913-287-7977
Practice Address - Fax:913-273-2502
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS613791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS61379OtherDENTAL LICENSE