Provider Demographics
NPI:1689790974
Name:WINTERS, KEVIN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:L
Last Name:WINTERS
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 1:6836 BEE CAVES RD
Mailing Address - Street 2:BUILDING ONE, STE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-347-0044
Mailing Address - Fax:
Practice Address - Street 1:6836 BEE CAVES RD
Practice Address - Street 2:BUILDING ONE, STE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-347-0044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX328131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice