Provider Demographics
NPI:1073095428
Name:PLUNKETT, ROHSHANA (RDA)
Entity Type:Individual
Prefix:
First Name:ROHSHANA
Middle Name:
Last Name:PLUNKETT
Suffix:
Gender:F
Credentials:RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 ROCK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010
Mailing Address - Country:US
Mailing Address - Phone:760-420-5369
Mailing Address - Fax:760-637-5705
Practice Address - Street 1:9717 MISSION GORGE RD
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071
Practice Address - Country:US
Practice Address - Phone:760-420-5369
Practice Address - Fax:760-637-5705
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-02
Last Update Date:2018-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDA50568126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant