Provider Demographics
NPI:1982859120
Name:O'BRIEN, RANI DENNISON (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:RANI
Middle Name:DENNISON
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48491 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-3281
Mailing Address - Country:US
Mailing Address - Phone:586-930-1919
Mailing Address - Fax:
Practice Address - Street 1:48491 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-3281
Practice Address - Country:US
Practice Address - Phone:586-930-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019494122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist