Provider Demographics
NPI:1356849558
Name:CATHEY FAMILY DENTISTRY PLLC
Entity Type:Organization
Organization Name:CATHEY FAMILY DENTISTRY PLLC
Other - Org Name:DERAN CATHEY DDS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/ DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DERAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CATHEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:662-662-5500
Mailing Address - Street 1:663 W SERVICE DR
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MS
Mailing Address - Zip Code:38618-3822
Mailing Address - Country:US
Mailing Address - Phone:662-622-5500
Mailing Address - Fax:662-622-0004
Practice Address - Street 1:663 W SERVICE DR
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MS
Practice Address - Zip Code:38618-3822
Practice Address - Country:US
Practice Address - Phone:662-622-5500
Practice Address - Fax:662-622-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2795-941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty