Healthcare Provider Details

I. General information

NPI: 1083151617
Provider Name (Legal Business Name): KAYDEN WELCH DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2017
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 MENTOR AVE STE 110
MENTOR OH
44060-8712
US

IV. Provider business mailing address

1034 W JACKSON ST
PAINESVILLE OH
44077-2529
US

V. Phone/Fax

Practice location:
  • Phone: 435-313-3066
  • Fax:
Mailing address:
  • Phone: 435-313-3066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30028470
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: