Provider Demographics
NPI:1902900947
Name:EMMONS, RHONDA KAY (DDS)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:KAY
Last Name:EMMONS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 BAINBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-6465
Mailing Address - Country:US
Mailing Address - Phone:469-762-3115
Mailing Address - Fax:
Practice Address - Street 1:201 LAURENCE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032-2069
Practice Address - Country:US
Practice Address - Phone:972-771-8383
Practice Address - Fax:972-722-6677
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17247122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX17247OtherCHIP NUMBER