Provider Demographics
NPI:1649312091
Name:O'DELL, RACHEL E (DDS)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:E
Last Name:O'DELL
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 1:3140 E BROAD ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BEXLEY
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2066
Mailing Address - Country:US
Mailing Address - Phone:614-231-6825
Mailing Address - Fax:614-231-8755
Practice Address - Street 1:3140 E BROAD ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BEXLEY
Practice Address - State:OH
Practice Address - Zip Code:43209-2066
Practice Address - Country:US
Practice Address - Phone:614-231-6825
Practice Address - Fax:614-231-8755
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21798122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist