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General NPI Number Information
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NPI Number | 1114639044
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Entity Type | Individual
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Provider Name | RACHEL DIZON RDH
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Gender | Female
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Dates
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Enumeration Date | 12/22/2022
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Last Update Date | 09/14/2025
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Provider Practice Location Address
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Address Line | 164 E H ST
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City | BENICIA
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State | CA
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Zip | 94510-3231
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Country | US
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Telephone | 707-745-1994
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Fax |
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Provider Business Mailing Address
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Address Line | 242 W M ST
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City | BENICIA
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State | CA
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Zip | 94510-2706
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Country | US
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Telephone | 360-584-8339
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 33596
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License Number State | CA
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