Provider Demographics
NPI:1194840256
Name:ROTHSCHILD, KENNETH I (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:I
Last Name:ROTHSCHILD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 SOUTH KING ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175
Mailing Address - Country:US
Mailing Address - Phone:703-777-3150
Mailing Address - Fax:703-777-7274
Practice Address - Street 1:823 SOUTH KING ST
Practice Address - Street 2:SUITE E
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175
Practice Address - Country:US
Practice Address - Phone:703-777-3150
Practice Address - Fax:703-777-2464
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401005883122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist