Healthcare Provider Details

I. General information

NPI: 1417164393
Provider Name (Legal Business Name): RACHEL LYANN STONE RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6262 ESCONDIDO DR
EL PASO TX
79912-1903
US

IV. Provider business mailing address

6262 ESCONDIDO DR
EL PASO TX
79912-1903
US

V. Phone/Fax

Practice location:
  • Phone: 706-587-7130
  • Fax:
Mailing address:
  • Phone: 706-587-7130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number12747
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH010003
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number3488
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number4118
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: