Provider Demographics
NPI:1326600917
Name:MYRON, KATHERINE CHEFFINS (DDS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CHEFFINS
Last Name:MYRON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5828 LANDERBROOK DRIVE
Mailing Address - Street 2:SUITE 124
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124
Mailing Address - Country:US
Mailing Address - Phone:440-483-1003
Mailing Address - Fax:
Practice Address - Street 1:5828 LANDERBROOK DRIVE
Practice Address - Street 2:SUITE 124
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124
Practice Address - Country:US
Practice Address - Phone:440-483-1003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.004071122300000X
OH30.0269481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist