Provider Demographics
NPI:1720312804
Name:ALLMAN-BAILEY, KENDAL (DDS)
Entity type:Individual
Prefix:DR
First Name:KENDAL
Middle Name:
Last Name:ALLMAN-BAILEY
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 1:6314 62ND AVENUE CT NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-6694
Mailing Address - Country:US
Mailing Address - Phone:805-637-9812
Mailing Address - Fax:
Practice Address - Street 1:5101 N PEARL ST STE B
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:WA
Practice Address - Zip Code:98407-3212
Practice Address - Country:US
Practice Address - Phone:253-302-3980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA587841223G0001X
WADE60521019122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice