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NPI Code Detail

MEDICARE: DR. OLIVIA SUZANNE RAUSCHENBACH DDS

MEDICARE: DR. OLIVIA SUZANNE RAUSCHENBACH DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist61959KS
21223G0001XGeneral Practice Dentistry2017017101MO

General Provider Information

NPI Number : 1811426679
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OLIVIA SUZANNE RAUSCHENBACH DDS
Provider Business Mailing Address
First Line : 200 WALNUT ST APT 304
Second Line :
City : KANSAS CITY
State : MO
Zip : 64106-1024
Country : US
Telephone Number : 605-351-7611
Fax Number :
Provider Business Practice Location Address
First Line : 3908 S NOLAND RD
Second Line :
City : INDEPENDENCE
State : MO
Zip : 64055-3347
Country : US
Telephone Number : 816-461-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2017
Last Update Date : 08/01/2022

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