Provider Demographics
NPI:1932411667
Name:MCKENDALL, ALEXIS (DDS)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:MCKENDALL
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 1:8000 N STADIUM DR # 26
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1823
Mailing Address - Country:US
Mailing Address - Phone:713-780-5680
Mailing Address - Fax:
Practice Address - Street 1:409 ROLAND AVE
Practice Address - Street 2:
Practice Address - City:OWENTON
Practice Address - State:KY
Practice Address - Zip Code:40359-1401
Practice Address - Country:US
Practice Address - Phone:502-484-5888
Practice Address - Fax:859-567-1253
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX264221223D0001X
KY10133122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public Health