Provider Demographics
NPI:1497167431
Name:KINDLER, JUSTIN KEITH (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:KEITH
Last Name:KINDLER
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 MONARCH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1875
Mailing Address - Country:US
Mailing Address - Phone:859-368-7337
Mailing Address - Fax:
Practice Address - Street 1:1001 MONARCH ST STE 210
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1875
Practice Address - Country:US
Practice Address - Phone:859-368-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-26
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012612A122300000X
FLDN20554122300000X
TN9825122300000X
KY9431122300000X
KY10841223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist