Provider Demographics
NPI:1205247434
Name:KENDALL, SAMANTHA (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:
Last Name:KENDALL
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 1:1400 S NEW RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-3738
Mailing Address - Country:US
Mailing Address - Phone:609-641-5400
Mailing Address - Fax:
Practice Address - Street 1:1400 S NEW RD
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-3738
Practice Address - Country:US
Practice Address - Phone:609-641-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-09
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102538122300000X
NY0580081223G0001X
NJ22DI02870500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice