Provider Demographics
NPI:1275035966
Name:REEDY, RACHEL YOUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:YOUNG
Last Name:REEDY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:59 S IDLEWILD ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3926
Mailing Address - Country:US
Mailing Address - Phone:901-726-9525
Mailing Address - Fax:
Practice Address - Street 1:59 S IDLEWILD ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3926
Practice Address - Country:US
Practice Address - Phone:901-726-9525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-08
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5968235Z00000X
TN125571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist