Provider Demographics
NPI:1235134503
Name:KLEMMEDSON, DANIEL JAMES (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAMES
Last Name:KLEMMEDSON
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Gender:
Credentials:DDS, MD
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Mailing Address - Street 1:3150 N SWAN RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1227
Mailing Address - Country:US
Mailing Address - Phone:520-745-6531
Mailing Address - Fax:520-790-3817
Practice Address - Street 1:3655 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2933
Practice Address - Country:US
Practice Address - Phone:520-767-0390
Practice Address - Fax:520-309-2593
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2025-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ16321204E00000X
AZ27741223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery