Provider Demographics
NPI:1306406764
Name:KINARD, BRYCE WILLIAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:WILLIAM
Last Name:KINARD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 COURT AVE
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1741
Mailing Address - Country:US
Mailing Address - Phone:402-850-5203
Mailing Address - Fax:
Practice Address - Street 1:801 S VICTORIA AVE STE 201
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5371
Practice Address - Country:US
Practice Address - Phone:805-665-3925
Practice Address - Fax:805-665-3926
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV72301223G0001X
CA1080431223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice