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General NPI Number Information
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NPI Number | 1760770143
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Entity Type | Individual
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Provider Name | KIMANH KENNELLY DDS
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Gender | Female
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 12999 W BOWLES DR
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City | LITTLETON
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State | CO
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Zip | 80127-4641
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Country | US
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Telephone | 303-989-9010
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Fax |
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Provider Business Mailing Address
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Address Line | 3146 S GENEVA ST
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City | DENVER
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State | CO
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Zip | 80231-4733
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Country | US
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Telephone | 585-899-0124
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 055527
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 201957
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License Number State | CO
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