Provider Demographics
NPI:1205600814
Name:DODDS, KENDRA
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:DODDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2902 WOODWAY AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-2751
Mailing Address - Country:US
Mailing Address - Phone:937-361-8843
Mailing Address - Fax:
Practice Address - Street 1:2902 WOODWAY AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-2751
Practice Address - Country:US
Practice Address - Phone:937-361-8843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide