Provider Demographics
NPI:1043346125
Name:KINDSETH, JEFFREY R (DDS)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:R
Last Name:KINDSETH
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 1:24721 LA PLZ
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2509
Mailing Address - Country:US
Mailing Address - Phone:949-661-2152
Mailing Address - Fax:
Practice Address - Street 1:24721 LA PLZ
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2509
Practice Address - Country:US
Practice Address - Phone:949-661-2152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA391681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice