MEDICARE: RHONDA L KEARNEY, DDS, MS, 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	1223P0221X	Pediatric Dentistry	7998	NC

General Provider Information

NPI Number	:	1699074112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RHONDA L KEARNEY, DDS, MS, PLLC

Provider Business Mailing Address
First Line	:	451 RUIN CREEK RD
Second Line	:	205
City	:	HENDERSON
State	:	NC
Zip	:	27536-2878
Country	:	US
Telephone Number	:	252-492-5437
Fax Number	:	252-492-5440

Provider Business Practice Location Address
First Line	:	451 RUIN CREEK RD.
Second Line	:	205
City	:	HENDERSON
State	:	NC
Zip	:	27536-0000
Country	:	US
Telephone Number	:	252-492-5437
Fax Number	:	252-492-5440

Authorized Official
Title or Position	:	OWNER/PEDIATRIC DENTIST
Name	:	DR. RHONDA KEARNEY
Credential	:	DDS, MS
Telephone Number	:	252-492-5437

Provider Enumeration Date	:	03/23/2011
Last Update Date	:	03/07/2023

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