Provider Demographics
NPI:1689677098
Name:KEMP, WILLIAM JAMES JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JAMES
Last Name:KEMP
Suffix:JR
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 1:2455 I 40 W
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1852
Mailing Address - Country:US
Mailing Address - Phone:806-350-5437
Mailing Address - Fax:806-350-5438
Practice Address - Street 1:2455 I 40 W
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1852
Practice Address - Country:US
Practice Address - Phone:806-350-5437
Practice Address - Fax:806-350-5438
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110971223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009855001Medicaid
TXT14157Medicare UPIN