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General NPI Number Information
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NPI Number | 1528991015
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Entity Type | Individual
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Provider Name | KATELYN RAE REILLY DMD
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Gender | Female
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Dates
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Enumeration Date | 06/04/2026
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Last Update Date | 06/04/2026
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Provider Practice Location Address
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Address Line | 4727 E PECOS RD STE 101
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City | GILBERT
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State | AZ
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Zip | 85295-0481
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Country | US
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Telephone | 480-807-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 6233 W BEHREND DR APT 1072
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City | GLENDALE
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State | AZ
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Zip | 85308-6924
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Country | US
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Telephone |
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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 | D012828
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License Number State | AZ
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