Provider Demographics
NPI:1750171096
Name:SLAGLE, REBEKAH (DDS)
Entity type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:
Last Name:SLAGLE
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9244 W MASON RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-9043
Mailing Address - Country:US
Mailing Address - Phone:419-203-9363
Mailing Address - Fax:
Practice Address - Street 1:425 W RUSSELL RD
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-1454
Practice Address - Country:US
Practice Address - Phone:937-492-2848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.027963122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist