Healthcare Provider Details

I. General information

NPI: 1538724133
Provider Name (Legal Business Name): AMANDA JO KATEN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12442 SW 119TH CT
MIAMI FL
33186-5184
US

IV. Provider business mailing address

12442 SW 119TH CT
MIAMI FL
33186-5184
US

V. Phone/Fax

Practice location:
  • Phone: 407-450-9636
  • Fax:
Mailing address:
  • Phone: 407-450-9636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN32037
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: