Provider Demographics
NPI:1679887111
Name:HAMEL, RACHEAL MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:RACHEAL
Middle Name:MARIE
Last Name:HAMEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RACHEAL
Other - Middle Name:MARIE
Other - Last Name:PEAVIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1401 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-3313
Mailing Address - Country:US
Mailing Address - Phone:859-655-6100
Mailing Address - Fax:859-655-6148
Practice Address - Street 1:1401 MADISON AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011
Practice Address - Country:US
Practice Address - Phone:859-655-6100
Practice Address - Fax:859-655-6148
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-023279122300000X
KY89641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100143670Medicaid