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General NPI Number Information
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NPI Number | 1821359456
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Entity Type | Individual
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Provider Name | SARAH KENNEALY DDS
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Gender | Female
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 1451 BELLE HAVEN RD STE 310
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City | ALEXANDRIA
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State | VA
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Zip | 22307-1201
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Country | US
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Telephone | 703-910-3182
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Fax |
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Provider Business Mailing Address
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Address Line | 1451 BELLE HAVEN RD STE 310
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City | ALEXANDRIA
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State | VA
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Zip | 22307-1201
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Country | US
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Telephone | 703-910-3182
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401413595
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License Number State | VA
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