Provider Demographics
NPI:1700983764
Name:KAPPENMAN, TAMI J IX (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAMI
Middle Name:J
Last Name:KAPPENMAN
Suffix:IX
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 1:46684 269TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-8020
Mailing Address - Country:US
Mailing Address - Phone:605-759-8253
Mailing Address - Fax:
Practice Address - Street 1:5704 W 41ST ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-1011
Practice Address - Country:US
Practice Address - Phone:605-361-9288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM7911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice