Provider Demographics
NPI:1780315648
Name:CHARLES R. KENDALL, DDS LLC
Entity type:Organization
Organization Name:CHARLES R. KENDALL, DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:KENDALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-340-8300
Mailing Address - Street 1:16971 W 94TH ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1939
Mailing Address - Country:US
Mailing Address - Phone:913-340-8300
Mailing Address - Fax:913-440-0299
Practice Address - Street 1:16971 W 94TH ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1939
Practice Address - Country:US
Practice Address - Phone:913-340-8300
Practice Address - Fax:913-440-0299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty