Provider Demographics
NPI:1083783831
Name:KOKKINEN, KENNETH ALYN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:ALYN
Last Name:KOKKINEN
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 1:10851 RHODE ISLAND AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55438-2393
Mailing Address - Country:US
Mailing Address - Phone:952-884-5361
Mailing Address - Fax:
Practice Address - Street 1:10851 RHODE ISLAND AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55438-2393
Practice Address - Country:US
Practice Address - Phone:952-884-5361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN100561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice