Provider Demographics
NPI:1861221962
Name:HEGGEMANN, KAYDEN ELIZABETH (DMD)
Entity type:Individual
Prefix:DR
First Name:KAYDEN
Middle Name:ELIZABETH
Last Name:HEGGEMANN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4561 MAINE ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62305-5851
Mailing Address - Country:US
Mailing Address - Phone:217-228-1085
Mailing Address - Fax:
Practice Address - Street 1:3915 MAINE ST STE 1
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62305-5843
Practice Address - Country:US
Practice Address - Phone:217-224-4828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0353661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice