MEDICARE: DR. KATHERINE R. MORGNTI IV D.D.S., M.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0401410194	VA
2	122300000X	Dentist	0401410194	VA

General Provider Information

NPI Number	:	1326031626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHERINE R. MORGNTI IV D.D.S., M.P.H.

Provider Business Mailing Address
First Line	:	335 S FAYETTE ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-5936
Country	:	US
Telephone Number	:	703-519-8559
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 LUKE AVE SW
Second Line	:	BOLLING AFB
City	:	BOLLING AFB
State	:	DC
Zip	:	20032-6400
Country	:	US
Telephone Number	:	202-404-4119
Fax Number	:	202-404-7366

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	09/11/2025

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