Basic Information
Provider Information
NPI: 1588228381
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RHEBI
FirstName: NADIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: BDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 611 N IRON BRIDGE WAY
Address2:  
City: SPOKANE
State: WA
PostalCode: 992024932
CountryCode: US
TelephoneNumber: 5094448888
FaxNumber:  
Practice Location
Address1: 203 E DALKE AVE
Address2:  
City: SPOKANE
State: WA
PostalCode: 992088112
CountryCode: US
TelephoneNumber: 5094448200
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/26/2019
LastUpdateDate: 05/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/06/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223G0001X60938413WAN Dental ProvidersDentistGeneral Practice
122300000XDE60938413WAY Dental ProvidersDentist 

No ID Information.


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