Provider Demographics
NPI:1588919401
Name:DOAN, RACHEL (DDS)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:DOAN
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 1:5669 MAHONING AVE STE A
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2339
Mailing Address - Country:US
Mailing Address - Phone:307-922-7493
Mailing Address - Fax:330-792-1128
Practice Address - Street 1:5669 MAHONING AVE STE A
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2339
Practice Address - Country:US
Practice Address - Phone:330-792-2749
Practice Address - Fax:330-792-1128
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.023895122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0136814Medicaid