MEDICARE: ALEJANDRA KATES DDS

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	1223P0221X	Pediatric Dentistry	DN 21046	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568850972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRA KATES DDS

Provider Business Mailing Address
First Line	:	777 DELTONA BLVD STE 9
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32725-7174
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2435 S VOLUSIA AVE STE D2
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-7643
Country	:	US
Telephone Number	:	386-878-4395
Fax Number	:

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

Provider Enumeration Date	:	01/07/2015
Last Update Date	:	11/10/2022

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