Provider Demographics
NPI:1689870693
Name:LENNON, KAREN MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:LENNON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 WATERFRONT PARKWALL
Mailing Address - Street 2:BUILDING 400
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206
Mailing Address - Country:US
Mailing Address - Phone:316-687-2100
Mailing Address - Fax:316-687-1024
Practice Address - Street 1:1700 WATERFRONT PARKWALL
Practice Address - Street 2:BUILDING 400
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206
Practice Address - Country:US
Practice Address - Phone:316-687-2100
Practice Address - Fax:316-687-1024
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6308122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist