Provider Demographics
NPI:1730646597
Name:DENTON, KATHLEEN ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:ELIZABETH
Last Name:DENTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:KENDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16581 W BELL RD STE 108
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-0004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16581 W BELL RD STE 108
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-0004
Practice Address - Country:US
Practice Address - Phone:480-795-2420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10722122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty