MEDICARE: JENNA SEDBERRY DDS PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1356032874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENNA SEDBERRY DDS PLLC

Provider Business Mailing Address
First Line	:	106 WOODSIDE DR
Second Line	:
City	:	ROCKINGHAM
State	:	NC
Zip	:	28379-8010
Country	:	US
Telephone Number	:	910-997-1276
Fax Number	:

Provider Business Practice Location Address
First Line	:	617 S LONG DR
Second Line	:
City	:	ROCKINGHAM
State	:	NC
Zip	:	28379-4313
Country	:	US
Telephone Number	:	910-997-1276
Fax Number	:

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	DR. JENNA ELISE SEDBERRY
Credential	:	DDS
Telephone Number	:	910-997-1276

Provider Enumeration Date	:	05/16/2023
Last Update Date	:	05/16/2023

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