Individual
DR. KENAYSHA ESHONJI GADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5638 NC HIGHWAY 42 W STE 109, GARNER, NC 27529-7998
(919) 772-1463
Mailing address
5638 NC HIGHWAY 42 W STE 109, GARNER, NC 27529-7998
(919) 772-1463
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7850
NC
1223P0221X
Pediatric Dentistry
Primary
7850
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89-045YU
—
NC
01
—
9026U
BLUE CROSS BLUE SHIELD NC
—
Enumeration date
08/25/2006
Last updated
05/22/2024
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