Individual provider Active NPI

Lawrence Robert Rehn, DDS

  • General Practice Dentistry
  • Grand Coulee, WA
National Provider Identifier
1689685588
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00006066 Issued in WA
Practice address
410 Burdin Blvd
Grand Coulee, WA 99133-0005
Phone
(509) 633-2761
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE00006066 WA Primary

Addresses

Primary practice location

410 Burdin Blvd
Grand Coulee, WA 99133-0005

Mailing address

PO Box 5
Grand Coulee, WA 99133-0005
Phone (509) 633-2761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161214001865 WA Order and Referring Only - DentistPractitioner - Dentist 9133409857

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00006066WAMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689685588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "city": "GRAND COULEE",
            "state": "WA",
            "postal_code": "991330005",
            "telephone_number": "509-633-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 BURDIN BLVD",
            "city": "GRAND COULEE",
            "state": "WA",
            "postal_code": "991330005",
            "telephone_number": "509-633-2761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REHN",
        "first_name": "LAWRENCE",
        "middle_name": "ROBERT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Coulee, WA

Sources for this page

Verify at the official NPI Registry.