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General NPI Number Information
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NPI Number | 1558780494
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Entity Type | Organization
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Legal Business Name | KATHERINE AHN DDS A DENTAL CORPORATION
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Dates
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Enumeration Date | 04/08/2014
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Last Update Date | 04/08/2014
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Provider Practice Location Address
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Address Line | 7801 CENTER AVE SUITE 101
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-9110
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Country | US
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Telephone | 213-230-2400
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Fax | 714-230-2431
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Provider Business Mailing Address
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Address Line | 7801 CENTER AVE SUITE 201
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-9110
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Country | US
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Telephone | 213-230-2400
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Fax | 714-230-2431
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE AHN
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Credential | DDS
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Telephone | 714-230-2400
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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 | 41055
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License Number State | CA
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