Provider Demographics
NPI:1861041097
Name:ATKINSON, KASHAUNDRA (RDH)
Entity Type:Individual
Prefix:
First Name:KASHAUNDRA
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:KASHAUNDRA
Other - Middle Name:
Other - Last Name:LINDLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDH
Mailing Address - Street 1:4515 POPLAR AVE STE 406
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-7508
Mailing Address - Country:US
Mailing Address - Phone:870-225-9995
Mailing Address - Fax:
Practice Address - Street 1:4515 POPLAR AVE STE 406
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-7508
Practice Address - Country:US
Practice Address - Phone:901-683-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7531124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist