Provider Demographics
NPI:1144226937
Name:CARNEY, JACQUELINE M (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:M
Last Name:CARNEY
Suffix:
Gender:F
Credentials:DDS, MS
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Mailing Address - Street 1:1470 PANTOPS MOUNTAIN PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-4662
Mailing Address - Country:US
Mailing Address - Phone:494-817-1817
Mailing Address - Fax:434-817-1819
Practice Address - Street 1:1470 PANTOPS MOUNTAIN PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4662
Practice Address - Country:US
Practice Address - Phone:494-817-1817
Practice Address - Fax:434-817-1819
Is Sole Proprietor?:No
Enumeration Date:2005-06-26
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA04014104631223P0221X, 1223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223D0004XDental ProvidersDentistDentist Anesthesiologist