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NPI Code Detail

MEDICARE: DR. RACHEL NICOLE CALLOWAY DDS

MEDICARE: DR. RACHEL NICOLE CALLOWAY 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
1122300000XDentist13245NC
21223G0001XGeneral Practice Dentistry13245NC
3125Q00000XOral Medicine Dentistry13245NC
4390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1588369813
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RACHEL NICOLE CALLOWAY DDS
Provider Business Mailing Address
First Line : 708 WANDERING WAY DR
Second Line :
City : WAXHAW
State : NC
Zip : 28173-7021
Country : US
Telephone Number : 704-516-1015
Fax Number :
Provider Business Practice Location Address
First Line : 1000 BLYTHE BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-5812
Country : US
Telephone Number : 704-355-2165
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2023
Last Update Date : 01/20/2026

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