Rackham Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

License

27186 Issued in TX

Legal business name

RACKHAM DENTAL LLC

Doing business as

Kids N More Dentist

Practice address

6658 Summer Fest Drive
San Antonio, TX 78244

Phone

(801) 920-8772

NPI assigned

Sep 16, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Joshua Lee Rackham, DMDNPI 1134431315

Title

Dentist

Phone

(801) 920-8772

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kids N More Dentist Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joshua L Rackham, DMD

  • Dentist
  • San Antonio, TX
  • NPI 1134431315
  Authorized official Same address or phone

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1699144022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201315",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782208315",
            "telephone_number": "801-920-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6658 SUMMER FEST DRIVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78244",
            "telephone_number": "801-920-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RACKHAM DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "RACKHAM",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "801-920-8772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "27186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214414901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids N More Dentist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brent Rachall, DPT
• Rachel Duran Tellez OD PA
• Rachel Hedrick, PSYD, PLLC
• Rachel Saravia Rachel Saravia, PH.D
• Tracey Racinowski, RN
• Joshua L Rackham, DMD
• Keith Rackley, CRNA
• Tanya Marie Rackley, M.D.
• Ashley Jordan Rackow
• Toni Wynn Racoma, O.D.

• Dentist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.