Provider Demographics
NPI:1225284466
Name:KLUENDER, RANDY LEE
Entity Type:Individual
Prefix:
First Name:RANDY
Middle Name:LEE
Last Name:KLUENDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13065 E 17TH AVE
Mailing Address - Street 2:MAIL STOP F840
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2532
Mailing Address - Country:US
Mailing Address - Phone:303-724-6931
Mailing Address - Fax:303-724-6935
Practice Address - Street 1:13065 E 17TH AVE
Practice Address - Street 2:MAIL STOP F840
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2532
Practice Address - Country:US
Practice Address - Phone:303-724-6931
Practice Address - Fax:303-724-6935
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43991223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry