Provider Demographics
NPI:1013131291
Name:KUNDINGER, KIM KATHLEEN (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:KATHLEEN
Last Name:KUNDINGER
Suffix:
Gender:F
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1056 GOODLETTE RD N
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5488
Mailing Address - Country:US
Mailing Address - Phone:239-261-7091
Mailing Address - Fax:239-261-0537
Practice Address - Street 1:1056 GOODLETTE RD N
Practice Address - Street 2:SUITE 201
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5488
Practice Address - Country:US
Practice Address - Phone:239-261-7091
Practice Address - Fax:239-261-0537
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00118311223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics