Provider Demographics
NPI:1497766265
Name:KINDER, JOSEPH E
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:KINDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7210 MAPLECREST RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46835-1892
Mailing Address - Country:US
Mailing Address - Phone:260-485-5530
Mailing Address - Fax:260-485-8344
Practice Address - Street 1:7210 MAPLECREST RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46835-1892
Practice Address - Country:US
Practice Address - Phone:260-485-5530
Practice Address - Fax:260-485-8344
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12008123A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice