Provider Demographics
NPI:1508426263
Name:PAGOADA SEVILLA, KATERINE Y (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATERINE
Middle Name:Y
Last Name:PAGOADA SEVILLA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6164
Mailing Address - Country:US
Mailing Address - Phone:504-485-6575
Mailing Address - Fax:
Practice Address - Street 1:3625 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6164
Practice Address - Country:US
Practice Address - Phone:504-864-3109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-15
Last Update Date:2019-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6993122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist