Provider Demographics
NPI:1558428433
Name:VON POWER, CATHERINE (DDS DMD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:VON POWER
Suffix:
Gender:F
Credentials:DDS DMD
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:VON POWER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS DMD
Mailing Address - Street 1:1005 E WASHINGTON BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90021-3020
Mailing Address - Country:US
Mailing Address - Phone:213-749-0041
Mailing Address - Fax:
Practice Address - Street 1:1005 E WASHINGTON BLVD STE B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90021-3020
Practice Address - Country:US
Practice Address - Phone:213-749-0041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA364071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABO6633792OtherDEA REGISTRATION NUMBER