DR. ROSELYN BROOKS KENNEDY (NPI# 1922214691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922214691 |
| Entity Type | Individual |
| Full Name | DR. ROSELYN BROOKS KENNEDY |
| Other Name | DR. ROSELYN BROOKS |
| Credential | DMD |
| Practice Address |
1400 Walter Reed Rd Ste 200 Fayetteville NC 28304-4411 |
| Mailing Address |
2041 Silas Creek Pkwy Winston Salem NC 27103-5147 |
| Practice Telephone | 9108649884 |
| Practice Fax Number | 9103541399 |
| Mailing Telephone | 3367770303 |
| Mailing Fax Number | 3367773448 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2009-02-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
8365 | NC | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
30019228 | OH | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0102838 | 05 |
| Street Address |
1400 WALTER REED RD STE 200 |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-4411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861429284 | Thomas Hugo Hamilton Jr. | Dentist | 1400 Walter Reed Rd, Suite 200, Fayetteville, NC 28304-4409 | 2006-06-28 |
| 1528485968 | Biniam Tecle | Dentist | 1400 Walter Reed Rd, Fayetteville, NC 28304-4409 | 2014-03-24 |
| 1285919902 | Kingsley Oise Momodu | Dentist | 1400 Walter Reed Rd, Fayetteville, NC 28304-4409 | 2011-10-13 |
| 1285803197 | Rafael Rivera, Jr., Dds, Pllc | Dentist | 1400 Walter Reed Rd, Fayetteville, NC 28304-4409 | 2008-02-25 |
| 1952418618 | Mark Tague Carlson | Dentist | 1400 Walter Reed Rd, Suite 200, Fayetteville, NC 28304-4409 | 2006-08-25 |
| 1952313090 | Paige E Nance | Dentist | 1400 Walter Reed Rd, Suite 200, Fayetteville, NC 28304-4409 | 2006-08-13 |
| 1386677961 | Ballance & Derose Dds Pa | Dentist | 1400 Walter Reed Rd, Suite 200, Fayetteville, NC 28304-4409 | 2006-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366060618 | A Dental Home 4 Kidz | Dentist | 155 Carnegie Pl Ste 201, Fayetteville, GA 30214-3981 | 2020-07-13 |
| 1508334400 | Smile Shoppe Fayetteville Jeffrey D. Rhodes Dds Ms Pllc | Dentist | 3484 W Wedington Dr, Fayetteville, AR 72704-5730 | 2018-11-08 |
| 1134405848 | Eaglin Dental Group, Fayetteville | Dentist | 692 Glynn St N Ste S, Fayetteville, GA 30214-6705 | 2011-10-26 |
| 1689974362 | Karen Anne Green | Dentist | 1607 E Rainforest Rd, Fayetteville, AR 72703 | 2010-10-27 |
| 1083872915 | Shannitta Latrease Bridgers | Dentist | 1367 Walter Reed Rd, Suite 103, Fayetteville, NC 28304 | 2008-05-28 |
| 1346300209 | Pediatric Dentistry & Interceptive Orthodontics P.C. | Dentist | 8016 E Genesee St, Fayetteville, NY 13066-9692 | 2006-12-11 |
| 1710052279 | Warren Coleman Massey | Dentist | 3089 E Mission Blvd, Fayetteville, AR 72703-4385 | 2006-11-21 |
| 1154401057 | Triplett, Sanders, Tompkins, Smith Pediatric Dentistry | Dentist | 1607 E Rainforest Dr, Fayetteville, AR 72703-5385 | 2006-10-16 |
| 1255422424 | Fred B Dunkelberger | Dentist | 570 W Lanier Avenue, Bldg #2, Fayetteville, GA 30214 | 2006-09-27 |
| 1073537627 | Yvette Mcalister Stokes, Dds, Pa | Dentist | 1770 Metromedical Dr, Fayetteville, NC 28304-3861 | 2006-07-27 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on DR. ROSELYN BROOKS KENNEDY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.