Provider Demographics
NPI:1114412855
Name:GIOVANNINI, RACHEL (DDS)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:GIOVANNINI
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 1:9280 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-1913
Mailing Address - Country:US
Mailing Address - Phone:716-741-9774
Mailing Address - Fax:
Practice Address - Street 1:9280 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-1913
Practice Address - Country:US
Practice Address - Phone:716-741-9774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059733122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist