Healthcare Provider Details

I. General information

NPI: 1629274121
Provider Name (Legal Business Name): RHONDA J EVERETT DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 08/25/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 EL PASO DR., MSC 24001 HUNT SCHOOL OF DENTAL MEDICINE 3RD FLOO
EL PASO TX
79905-7990
US

IV. Provider business mailing address

5001 EL PASO DR., MSC 24001 HUNT SCHOOL OF DENTAL MEDICINE 3RD FLOO
EL PASO TX
79905
US

V. Phone/Fax

Practice location:
  • Phone: 915-215-4365
  • Fax:
Mailing address:
  • Phone: 702-774-2816
  • Fax: 702-774-2811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberLL13906
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number37457
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: