Provider Demographics
NPI:1194895698
Name:RAINIERI, FRANK A (DMD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:A
Last Name:RAINIERI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:95 TOP MEADOW LANE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:25411-6073
Mailing Address - Country:US
Mailing Address - Phone:304-258-1623
Mailing Address - Fax:304-258-1623
Practice Address - Street 1:261 BERKMORE PLACE
Practice Address - Street 2:SUITE 1B
Practice Address - City:BERKELEY SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:25411-6247
Practice Address - Country:US
Practice Address - Phone:304-258-1623
Practice Address - Fax:304-258-1623
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV31561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0134030000Medicaid