Healthcare Provider Details

I. General information

NPI: 1194630814
Provider Name (Legal Business Name): RACHEL WYNINGS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W 9TH ST
BERWICK PA
18603-3099
US

IV. Provider business mailing address

105 W 9TH ST
BERWICK PA
18603-3099
US

V. Phone/Fax

Practice location:
  • Phone: 570-752-4542
  • Fax: 570-752-6806
Mailing address:
  • Phone: 570-752-4542
  • Fax: 570-752-6806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS046032
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: