Provider Demographics
NPI:1871600841
Name:KIENE, JAMES R JR (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:KIENE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13308 W 74TH ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-4420
Mailing Address - Country:US
Mailing Address - Phone:913-825-9373
Mailing Address - Fax:913-631-9299
Practice Address - Street 1:11005 W 60TH ST
Practice Address - Street 2:STE. 240
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-2913
Practice Address - Country:US
Practice Address - Phone:913-631-5622
Practice Address - Fax:913-631-9299
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS62851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice