Provider Demographics
NPI:1447462338
Name:RANKOWITZ, JOAN D (RDH)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:D
Last Name:RANKOWITZ
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 BECKWITH HILL DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:CT
Mailing Address - Zip Code:06420-4115
Mailing Address - Country:US
Mailing Address - Phone:860-859-1341
Mailing Address - Fax:
Practice Address - Street 1:20 HARTFORD RD
Practice Address - Street 2:SUITE 34
Practice Address - City:SALEM
Practice Address - State:CT
Practice Address - Zip Code:06420-3800
Practice Address - Country:US
Practice Address - Phone:860-859-1341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002852124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist