Provider Demographics
NPI:1649262197
Name:BEAN, RHONDA LONELL (DDS)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:LONELL
Last Name:BEAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 CAMBRIDGE ST STE 3510
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2032
Mailing Address - Country:US
Mailing Address - Phone:713-201-0693
Mailing Address - Fax:
Practice Address - Street 1:17214 WOODLAND CREEK LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-4388
Practice Address - Country:US
Practice Address - Phone:713-201-0693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14840122300000X, 1223D0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentistGroup - Single Specialty
No1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1109415-02Medicaid