Provider Demographics
NPI:1427139849
Name:DAVIS, RHEA (DDS)
Entity type:Individual
Prefix:DR
First Name:RHEA
Middle Name:
Last Name:DAVIS
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 1:13555 WELLINGTON CENTER CIRCLE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155
Mailing Address - Country:US
Mailing Address - Phone:703-754-1580
Mailing Address - Fax:703-754-1897
Practice Address - Street 1:13555 WELLINGTON CENTER CIRCLE
Practice Address - Street 2:SUITE 105
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155
Practice Address - Country:US
Practice Address - Phone:703-754-1580
Practice Address - Fax:703-754-1897
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014106421223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10642OtherDELTA DENTAL PROVIDER ID#
VA9179290Medicaid
VA1580984OtherUNITED CONCORDIA PROVIDER
VA107236Medicaid