Rachael R Hogan, DDS
Individual provider Active NPI General Practice Dentistry · La Conner, WA
NPI 1407926413 · NPPES record last updated Jul 30, 2013
Key facts
- NPI
- 1407926413
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DE00009338 (WA)
- Practice address
- 17395 Reservation Rd
La Conner, WA 98257-8802 - Phone
- (360) 466-3900
- Fax
- (360) 466-7301
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| DE00009338 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swinomish/Upper Skagit Dental Clinic | Past | Accepting new patients | |
| Swinomish Upper Skagit Dental | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE00009338 | WA | Yes |
Addresses
Primary practice location
17395 Reservation Rd
La Conner, WA 98257-8802
Mailing address
PO Box 332
17395 Reservation Rd
La Conner, WA 98257-0332
Phone (360) 466-3900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0174706 | Other | WA | LABOR AND INDUSTRIES |
| 5044490 | Medicaid | WA |
Other names
- Rachael Rosenfeld
Other providers in La Conner, WA
- Steven Bruce Gooding
- Alexis Govan
- Patricia J Harlan
- Marianne Haworth
- Teylor Hendricks
- Tamara M Holmes
- Internal Medicine Consultants NW PS
- Gary Clayton Isham
- Justin Iwasaki
- Sabrina James
All providers in La Conner, WA · General Practice Dentistry in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2013. 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.