Provider Demographics
NPI:1700961299
Name:KESS, BRADFORD LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:LEE
Last Name:KESS
Suffix:
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 1:3136 S MCCLINTOCK DR STE 1
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-8002
Mailing Address - Country:US
Mailing Address - Phone:440-596-2312
Mailing Address - Fax:
Practice Address - Street 1:3136 S MCCLINTOCK DR STE 1
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-8002
Practice Address - Country:US
Practice Address - Phone:440-596-2312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0102701223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics