Provider Demographics
NPI:1639187883
Name:SYKES, KENNETH E (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:E
Last Name:SYKES
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 1:1100 BRIDGEWOOD DR
Mailing Address - Street 2:SUITE 126
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-0826
Mailing Address - Country:US
Mailing Address - Phone:817-451-4911
Mailing Address - Fax:817-451-6443
Practice Address - Street 1:1100 BRIDGEWOOD DR
Practice Address - Street 2:SUITE 126
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-0826
Practice Address - Country:US
Practice Address - Phone:817-451-4911
Practice Address - Fax:817-451-6443
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD127041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD12704OtherSTATE LICENSE #