Provider Demographics
NPI:1831834639
Name:HUSSEIN, REEM RAHEEM (DDS)
Entity type:Individual
Prefix:
First Name:REEM
Middle Name:RAHEEM
Last Name:HUSSEIN
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 1:2020 N WEBB RD STE 301
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3410
Mailing Address - Country:US
Mailing Address - Phone:316-687-2110
Mailing Address - Fax:
Practice Address - Street 1:2020 N WEBB RD
Practice Address - Street 2:STE 301
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3410
Practice Address - Country:US
Practice Address - Phone:316-687-2110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSNA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty