Provider Demographics
NPI:1396890927
Name:CORMNEY, RHONDA H (DMD, PSC)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:H
Last Name:CORMNEY
Suffix:
Gender:F
Credentials:DMD, PSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 HAMPTON WAY STE 1
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8885
Mailing Address - Country:US
Mailing Address - Phone:859-623-7476
Mailing Address - Fax:859-623-7477
Practice Address - Street 1:519 HAMPTON WAY STE 1
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8885
Practice Address - Country:US
Practice Address - Phone:859-623-7476
Practice Address - Fax:859-623-7477
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY53301223P0221X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60053303Medicaid