Provider Demographics
NPI:1588180780
Name:PADILLA, KATHRYN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:PADILLA
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 1:10812 180TH CT NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7202
Mailing Address - Country:US
Mailing Address - Phone:425-503-3592
Mailing Address - Fax:
Practice Address - Street 1:10812 180TH CT NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7202
Practice Address - Country:US
Practice Address - Phone:425-503-3592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60782334122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist