Provider Demographics
NPI:1053988634
Name:ALUMBAUGH, REBECCA RUTH (DDS)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:RUTH
Last Name:ALUMBAUGH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 E HINES ST
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-1279
Mailing Address - Country:US
Mailing Address - Phone:816-457-8039
Mailing Address - Fax:
Practice Address - Street 1:121 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-1517
Practice Address - Country:US
Practice Address - Phone:417-422-4540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS61850122300000X
MO2021021255122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist