Individual provider Active NPI

Rachel Makenzie Healy

  • General Practice Dentistry
  • Rohnert Park, CA
National Provider Identifier
1750110748
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
110239 Issued in CA
Practice address
1301 Medical Center Dr
Rohnert Park, CA 94928-2902
Phone
(707) 623-9123
NPI assigned
Jul 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 110239 CA Primary

Addresses

Primary practice location

1301 Medical Center Dr
Rohnert Park, CA 94928-2902

Mailing address

277 Sequoia Ave
South San Francisco, CA 94080-1346
Phone (650) 438-0551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
110239CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1750110748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 SEQUOIA AVE",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940801346",
            "telephone_number": "650-438-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 MEDICAL CENTER DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282902",
            "telephone_number": "707-623-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEALY",
        "first_name": "RACHEL",
        "middle_name": "MAKENZIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.