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General NPI Number Information
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NPI Number | 1316316938
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Entity Type | Individual
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Provider Name | CAITLYN KENDRA AFFRUNTI D.D.S., M.S.
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Gender | Female
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Dates
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Enumeration Date | 09/24/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 303 BROOKSIDE AVE
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City | REDLANDS
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State | CA
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Zip | 92373-4617
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Country | US
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Telephone | 909-793-8837
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Fax |
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Provider Business Mailing Address
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Address Line | 15613 BEL RED RD STE A
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City | BELLEVUE
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State | WA
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Zip | 98008-2348
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Country | US
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Telephone | 425-883-8333
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 64861
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DE60517675
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 64861
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License Number State | CA
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