Provider Demographics
NPI:1477661643
Name:PEPE, KATHRYN (DDS)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:PEPE
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 1:1718 S 288TH ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-2981
Mailing Address - Country:US
Mailing Address - Phone:253-839-4111
Mailing Address - Fax:253-839-3573
Practice Address - Street 1:1718 S 288TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-2981
Practice Address - Country:US
Practice Address - Phone:253-839-4111
Practice Address - Fax:253-839-3573
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000082741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice