Basic Information
| Provider Information | |||||||||
| NPI: | 1427345958 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BELLAN | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | ROSEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DMD, MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13916 NICKLAUS DR | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662232999 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5126276270 | ||||||||
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| Practice Location | |||||||||
| Address1: | 101 N FM 548 | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | FORNEY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751265685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725521224 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2011 | ||||||||
| LastUpdateDate: | 11/17/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223X0400X | 24100 | TX | Y | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics |
No ID Information.