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NPI Code Detail

MEDICARE: CHRISTINA MCBRIDE KENERSON DMD

MEDICARE: CHRISTINA MCBRIDE KENERSON DMD
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
1390200000XStudent in an Organized Health Care Education/Training Program
21223G0001XGeneral Practice Dentistry103482CA

General Provider Information

NPI Number : 1598298150
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA MCBRIDE KENERSON DMD
Provider Business Mailing Address
First Line : 1551 FILBERT ST APT 4
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94123-3725
Country : US
Telephone Number : 201-919-4544
Fax Number :
Provider Business Practice Location Address
First Line : 2383 CALIFORNIA ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-2702
Country : US
Telephone Number : 415-854-5797
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2017
Last Update Date : 03/24/2020

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Directions to “ CHRISTINA MCBRIDE KENERSON DMD” Practice Location

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