Provider Demographics
NPI:1316103716
Name:KINSLER, JULIE DIANE (DDS)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:DIANE
Last Name:KINSLER
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 1:50530 WEEPING WILLOW RUN E
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-7510
Mailing Address - Country:US
Mailing Address - Phone:317-691-2088
Mailing Address - Fax:
Practice Address - Street 1:7750 W 200 S
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:IN
Practice Address - Zip Code:46571-9436
Practice Address - Country:US
Practice Address - Phone:260-768-7918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011248A122300000X
IL019.0275801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice