Provider Demographics
NPI:1366415853
Name:CHAIKIN, RACHELLE (DDS)
Entity type:Individual
Prefix:DR
First Name:RACHELLE
Middle Name:
Last Name:CHAIKIN
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 1:13 E AVENIDA SEBASTIAN
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87506
Mailing Address - Country:US
Mailing Address - Phone:719-588-6452
Mailing Address - Fax:
Practice Address - Street 1:13 E AVENIDA SEBASTIAN
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87506
Practice Address - Country:US
Practice Address - Phone:719-588-6452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9853122300000X
NMDD3274122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist