Provider Demographics
NPI:1013606037
Name:KITCHEN, ROSHAUNDA MONET (DMD)
Entity Type:Individual
Prefix:
First Name:ROSHAUNDA
Middle Name:MONET
Last Name:KITCHEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ROSHAUNDA
Other - Middle Name:MONET
Other - Last Name:MORENO KITCHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:2666 US 64 BUSINESS W
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-6802
Mailing Address - Country:US
Mailing Address - Phone:919-548-3686
Mailing Address - Fax:
Practice Address - Street 1:122 JOLLY ST
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2272
Practice Address - Country:US
Practice Address - Phone:919-496-3088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13174122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist