MEDICARE: RONDA L MCFADDEN 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
1	122300000X	Dentist	7087	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063497436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONDA L MCFADDEN DDS

Provider Business Mailing Address
First Line	:	1123 E KANSAS PLZ
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-5870
Country	:	US
Telephone Number	:	620-271-9200
Fax Number	:	620-271-9205

Provider Business Practice Location Address
First Line	:	1123 E KANSAS PLZ
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-5870
Country	:	US
Telephone Number	:	620-271-9200
Fax Number	:	620-271-9205

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	06/29/2015

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