Provider Demographics
NPI:1699074112
Name:RHONDA L KEARNEY, DDS, MS, PLLC
Entity type:Organization
Organization Name:RHONDA L KEARNEY, DDS, MS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:252-492-5437
Mailing Address - Street 1:451 RUIN CREEK RD
Mailing Address - Street 2:205
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-2878
Mailing Address - Country:US
Mailing Address - Phone:252-492-5437
Mailing Address - Fax:252-492-5440
Practice Address - Street 1:451 RUIN CREEK RD.
Practice Address - Street 2:205
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-0000
Practice Address - Country:US
Practice Address - Phone:252-492-5437
Practice Address - Fax:252-492-5440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC79981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCFK0720880OtherDEA NUMBER