Provider Demographics
NPI:1295288892
Name:TODD, RACHEL (DDS)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:TODD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:LOWRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2353 N FIELD ST APT 733
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-8239
Mailing Address - Country:US
Mailing Address - Phone:972-849-3927
Mailing Address - Fax:
Practice Address - Street 1:1809 YARMOUTH LN
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2900
Practice Address - Country:US
Practice Address - Phone:972-849-3927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-31
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX321091223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice