Provider Demographics
NPI:1740663079
Name:BAGINSKI, KENDALL LYNN
Entity type:Individual
Prefix:DR
First Name:KENDALL
Middle Name:LYNN
Last Name:BAGINSKI
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 1:709 BALLYBUNION CIR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-5125
Mailing Address - Country:US
Mailing Address - Phone:214-726-6651
Mailing Address - Fax:
Practice Address - Street 1:709 BALLYBUNION CIR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-5125
Practice Address - Country:US
Practice Address - Phone:214-726-6651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-06
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1510561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice