Provider Demographics
NPI:1295196731
Name:JOHN EDWARD KEMPTER DDS PLLC
Entity Type:Organization
Organization Name:JOHN EDWARD KEMPTER DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KEMPTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-782-0797
Mailing Address - Street 1:1000 COPPERFIELD BLVD NE STE 160
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2454
Mailing Address - Country:US
Mailing Address - Phone:704-782-0797
Mailing Address - Fax:704-782-0789
Practice Address - Street 1:1000 COPPERFIELD BLVD NE STE 154
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2454
Practice Address - Country:US
Practice Address - Phone:704-782-0797
Practice Address - Fax:704-782-0789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC86471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty