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General NPI Number Information
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NPI Number | 1932481132
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Entity Type | Individual
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Provider Name | ANGELA M KEARNEY D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 09/13/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4107 PORTSMOUTH BLVD
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City | CHESAPEAKE
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State | VA
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Zip | 23321-2140
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Country | US
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Telephone | 757-517-2438
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Fax |
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Provider Business Mailing Address
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Address Line | 619 SAUNDERS RD
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City | GATES
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State | NC
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Zip | 27937-9577
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Country | US
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Telephone | 252-287-5672
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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 | 0401413363
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License Number State | VA
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