Provider Demographics
NPI:1679608459
Name:KEVIN K. CHRISTENSEN, D.D.S., P.A.
Entity type:Organization
Organization Name:KEVIN K. CHRISTENSEN, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:316-522-4759
Mailing Address - Street 1:2860 S SENECA ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67217-2865
Mailing Address - Country:US
Mailing Address - Phone:316-522-4759
Mailing Address - Fax:316-522-3250
Practice Address - Street 1:2860 S SENECA ST
Practice Address - Street 2:SUITE C
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67217-2865
Practice Address - Country:US
Practice Address - Phone:316-522-4759
Practice Address - Fax:316-522-3250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental