Provider Demographics
NPI:1447954995
Name:RUIZ, RACHEL ALLEN (DMD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ALLEN
Last Name:RUIZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:ELIZABETH
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 BROAD ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3573
Mailing Address - Country:US
Mailing Address - Phone:919-286-6646
Mailing Address - Fax:919-286-6668
Practice Address - Street 1:1200 BROAD ST STE 300
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3573
Practice Address - Country:US
Practice Address - Phone:919-286-6646
Practice Address - Fax:919-286-6668
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC134321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice