Dylan Racha, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7292 Issued in LA

Practice address

3301 Veterans Memorial Blvd Ste 203
Metairie, LA 70002-8440

Phone

(504) 887-6453

NPI assigned

Apr 9, 2019

Last updated

Aug 9, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1790248524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6841 GLASS FACTORY RD",
            "city": "HOLLAND PATENT",
            "state": "NY",
            "postal_code": "133544135",
            "telephone_number": "315-794-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 VETERANS MEMORIAL BLVD STE 203",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700028440",
            "telephone_number": "504-887-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACHA",
        "first_name": "DYLAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7292",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• R. Daniel Jacob, M.D.,a.P.M.C.
• R. Joseph Tamimie, MD, Apmc (East Jefferson Occupational Medicine Clinic)
• Heather Nicole Rabassa
• Ronald P Rabin, MD
• Frank Rabito, M.D.
• Noah Daniel Rachal I, MA
• Jennifer Radecker, RRT
• Rachele Kelley Radelat, LOTR
• Barry L Radell, D.D.S.
• Jeanne M. Rademacher, M.D.

• General Practice Dentistry in Metairie, LA
• Providers in Metairie, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.