Provider Demographics
NPI:1881777498
Name:KITTLE, JENNIFER BUEHLER (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:BUEHLER
Last Name:KITTLE
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 1:10445 HIGH GRV
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8362
Mailing Address - Country:US
Mailing Address - Phone:317-846-9904
Mailing Address - Fax:
Practice Address - Street 1:9002 N MERIDIAN ST
Practice Address - Street 2:SUITE 111
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5381
Practice Address - Country:US
Practice Address - Phone:317-818-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009949122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist