Provider Demographics
NPI:1932383817
Name:DRISCOLL, RACHEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:DRISCOLL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:PITTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6310 NW HOGAN DR
Mailing Address - Street 2:APT 2
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64152-3103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1170 W KANSAS ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-2036
Practice Address - Country:US
Practice Address - Phone:816-716-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007028611122300000X
KS60528122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist