Provider Demographics
NPI:1932185519
Name:NEILL, REBECCA ANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANNE
Last Name:NEILL
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 1:7657 PIT RD
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-5395
Mailing Address - Country:US
Mailing Address - Phone:530-243-4617
Mailing Address - Fax:
Practice Address - Street 1:1350 CHURN CREEK RD
Practice Address - Street 2:SUITE F1
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-4087
Practice Address - Country:US
Practice Address - Phone:530-224-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6407122300000X
CA55160122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist