MEDICARE: RNK WILLIAMSBURG DENTAL 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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1801726179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RNK WILLIAMSBURG DENTAL PLLC

Provider Business Mailing Address
First Line	:	4680 MONTICELLO AVE STE 16A
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-8214
Country	:	US
Telephone Number	:	757-258-1042
Fax Number	:	757-258-1225

Provider Business Practice Location Address
First Line	:	4680 MONTICELLO AVE STE 16A
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-8214
Country	:	US
Telephone Number	:	757-258-1042
Fax Number	:	757-258-1225

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. ASHLYN FERGUSON
Credential	:
Telephone Number	:	313-421-1411

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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