MEDICARE: ADRIAN P REHAK 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
1	1223G0001X	General Practice Dentistry	6205	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326036179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIAN P REHAK DDS

Provider Business Mailing Address
First Line	:	1615 32ND ST NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402
Country	:	US
Telephone Number	:	319-294-2323
Fax Number	:	319-395-6715

Provider Business Practice Location Address
First Line	:	1615 32ND ST NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402
Country	:	US
Telephone Number	:	319-294-2323
Fax Number	:	319-395-6715

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	07/21/2022

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