Provider Demographics
NPI:1245083914
Name:SEDO, RONDA (RDH)
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:
Last Name:SEDO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 S RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:GARRETT
Mailing Address - State:IN
Mailing Address - Zip Code:46738-1970
Mailing Address - Country:US
Mailing Address - Phone:260-357-0077
Mailing Address - Fax:
Practice Address - Street 1:1359 S RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:GARRETT
Practice Address - State:IN
Practice Address - Zip Code:46738-1970
Practice Address - Country:US
Practice Address - Phone:260-357-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN13005336A124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist