Healthcare Provider Details
I. General information
NPI: 1114852720
Provider Name (Legal Business Name): KASIDEE CATHRYN WELLS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11 MEADOW BRANCH AVE
WINCHESTER VA
22601-6255
US
IV. Provider business mailing address
18560 HARMONY CHURCH RD
HAMILTON VA
20158-3520
US
V. Phone/Fax
- Phone: 540-698-3384
- Fax:
- Phone: 316-648-0133
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 4868 |
| License Number State | WV |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 0401420111 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: