Provider Demographics
NPI:1285915611
Name:JAMES, KENDALL WILLIAM (DMD)
Entity type:Individual
Prefix:DR
First Name:KENDALL
Middle Name:WILLIAM
Last Name:JAMES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 27TH AVE SE APT F
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2773
Mailing Address - Country:US
Mailing Address - Phone:612-624-3254
Mailing Address - Fax:612-626-2655
Practice Address - Street 1:515 DELAWARE ST. SE
Practice Address - Street 2:9-176 MOOS TOWER
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-624-6644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNTBP1223P0700X
MNS1721223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics