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NPI Code Detail

MEDICARE: KATELYN KCOMT DDS

MEDICARE:   KATELYN  KCOMT  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
11223G0001XGeneral Practice Dentistry111303CA
2122300000XDentist111303CA

General Provider Information

NPI Number : 1770373342
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN KCOMT DDS
Provider Business Mailing Address
First Line : 4161 REDONDO BEACH BLVD # 200
Second Line :
City : LAWNDALE
State : CA
Zip : 90260-3340
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4161 REDONDO BEACH BLVD # 200
Second Line :
City : LAWNDALE
State : CA
Zip : 90260-3340
Country : US
Telephone Number : 310-371-6513
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2025
Last Update Date : 05/08/2025

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Directions to “ KATELYN KCOMT DDS” Practice Location

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