Provider Demographics
NPI:1437508918
Name:HEEKE, KENDRA SHAYE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENDRA
Middle Name:SHAYE
Last Name:HEEKE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4886 PORT ROYAL RD STE 250
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-8802
Mailing Address - Country:US
Mailing Address - Phone:931-486-3232
Mailing Address - Fax:
Practice Address - Street 1:4886 PORT ROYAL RD STE 250
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-8802
Practice Address - Country:US
Practice Address - Phone:931-486-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10247122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist