Healthcare Provider Details

I. General information

NPI: 1588568372
Provider Name (Legal Business Name): KATHRYN KELLINY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3445 PACIFIC COAST HWY STE 305
TORRANCE CA
90505-6660
US

IV. Provider business mailing address

2233 VIA LA BREA
PALOS VERDES ESTATES CA
90274-1656
US

V. Phone/Fax

Practice location:
  • Phone: 310-539-5566
  • Fax:
Mailing address:
  • Phone: 424-241-6828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number113889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: