Provider Demographics
NPI:1588828842
Name:PYPER, KENDALL T (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENDALL
Middle Name:T
Last Name:PYPER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 OAK ST
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-1617
Mailing Address - Country:US
Mailing Address - Phone:503-874-9119
Mailing Address - Fax:503-874-9117
Practice Address - Street 1:214 OAK ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381
Practice Address - Country:US
Practice Address - Phone:503-874-9119
Practice Address - Fax:503-874-9117
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD91131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice