Provider Demographics
NPI:1154171098
Name:ELLIOT, RHINA (DDS)
Entity type:Individual
Prefix:
First Name:RHINA
Middle Name:
Last Name:ELLIOT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:RHINA
Other - Middle Name:
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2612 OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23513-4415
Mailing Address - Country:US
Mailing Address - Phone:347-779-5146
Mailing Address - Fax:
Practice Address - Street 1:2612 OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23513-4415
Practice Address - Country:US
Practice Address - Phone:347-779-5146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0000000001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice