Provider Demographics
NPI:1598553034
Name:SANDAL, KENDRA
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:SANDAL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5013 S LOUISE AVE UNIT 7122
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2268
Mailing Address - Country:US
Mailing Address - Phone:605-760-4776
Mailing Address - Fax:
Practice Address - Street 1:4310 W 59TH ST UNIT 9
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2315
Practice Address - Country:US
Practice Address - Phone:605-760-4776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier