1902900947 NPI number — RHONDA KAY EMMONS D.D.S.

Table of content: RHONDA KAY EMMONS D.D.S. (NPI 1902900947)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902900947 NPI number — RHONDA KAY EMMONS D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EMMONS
Provider First Name:
RHONDA
Provider Middle Name:
KAY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902900947
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1101 BAINBRIDGE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORNEY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75126-6465
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-762-3115
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 LAURENCE DR
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
HEATH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75032-2069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-771-8383
Provider Business Practice Location Address Fax Number:
972-722-6677
Provider Enumeration Date:
09/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  17247 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 17247 . This is a "CHIP NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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