Provider Demographics
NPI:1497958532
Name:GREENBERG, KATJA (DRMEDDENT,DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:KATJA
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:DRMEDDENT,DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 MISSISSIPPI ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-2928
Mailing Address - Country:US
Mailing Address - Phone:141-531-0277
Mailing Address - Fax:
Practice Address - Street 1:2001 UNION ST
Practice Address - Street 2:SUITE 482
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4114
Practice Address - Country:US
Practice Address - Phone:141-544-0810
Practice Address - Fax:141-544-0016
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA481341223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics