Rachel Fainman, DDS
Individual provider Active NPI Dentist · Montebello, NY
NPI 1114166113 · NPPES record last updated Jul 30, 2015
Key facts
- NPI
- 1114166113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 054403 (NY)
- Practice address
- 15 Indian Rock Shopping Plaza, RT 59
Montebello, NY 10901 - Phone
- (845) 357-7717
- NPI assigned
- Feb 13, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010040 | CT | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 054403 | NY | Yes |
| Dentist | 122300000X | 010040 | CT | |
| General Practice Dentistry | 1223G0001X | 054403 | NY |
Addresses
Primary practice location
15 Indian Rock Shopping Plaza, RT 59
Montebello, NY 10901
Mailing address
15 Indian Rock Shopping Plaza, RT 59
Montebello, NY 10901
Phone (845) 357-7717
Other providers in Montebello, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.