Provider Demographics
NPI:1750679759
Name:JAMES KERNS DMD PLLC
Entity Type:Organization
Organization Name:JAMES KERNS DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KERNS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-641-0414
Mailing Address - Street 1:6905 W BROWARD BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2903
Mailing Address - Country:US
Mailing Address - Phone:954-641-0414
Mailing Address - Fax:954-641-0418
Practice Address - Street 1:6905 W BROWARD BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2903
Practice Address - Country:US
Practice Address - Phone:954-641-0414
Practice Address - Fax:954-641-0418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17150122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty