Healthcare Provider Details

I. General information

NPI: 1659045961
Provider Name (Legal Business Name): KATHERINE SANCHEZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6284 PULLMAN DR
LEWIS CENTER OH
43035-7372
US

IV. Provider business mailing address

6284 PULLMAN DR
LEWIS CENTER OH
43035-7372
US

V. Phone/Fax

Practice location:
  • Phone: 740-657-1562
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number30.027682
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: