Provider Demographics
NPI:1235395880
Name:KEMPTON, JOHN DAVID (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:KEMPTON
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Mailing Address - Street 1:538 E 16TH ST
Mailing Address - Street 2:STE. 101
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-2028
Mailing Address - Country:US
Mailing Address - Phone:928-304-7100
Mailing Address - Fax:928-304-7105
Practice Address - Street 1:538 E 16TH ST
Practice Address - Street 2:STE. 101
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-2028
Practice Address - Country:US
Practice Address - Phone:928-304-7100
Practice Address - Fax:928-304-7105
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX236551223G0001X
UT7788150-99221223P0221X
AZD0085081223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ584421Medicaid