Provider Demographics
NPI:1649591256
Name:KITCHENS, BRANDON JEFFREY (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:JEFFREY
Last Name:KITCHENS
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 1:14114 TAYLOR LOOP RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-4308
Mailing Address - Country:US
Mailing Address - Phone:501-868-3331
Mailing Address - Fax:501-868-5323
Practice Address - Street 1:14114 TAYLOR LOOP RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-4308
Practice Address - Country:US
Practice Address - Phone:501-868-3331
Practice Address - Fax:501-868-5323
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR37781223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR182766608Medicaid