Provider Demographics
NPI:1023307659
Name:GOLD, RACHEL E (DMD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:E
Last Name:GOLD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:KY
Mailing Address - Zip Code:41074-1483
Mailing Address - Country:US
Mailing Address - Phone:859-261-0101
Mailing Address - Fax:
Practice Address - Street 1:1230 N FORT THOMAS AVE
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-1152
Practice Address - Country:US
Practice Address - Phone:859-446-6671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8994122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist