Healthcare Provider Details

I. General information

NPI: 1023975216
Provider Name (Legal Business Name): KATHRYN LOUISE KWOCHKA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5645 MAIN ST
FLUSHING NY
11355-5045
US

IV. Provider business mailing address

36 FEATHER LN
GUILFORD CT
06437-4908
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-1520
  • Fax: 718-445-4147
Mailing address:
  • Phone: 203-444-3441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: