Provider Demographics
NPI:1730807942
Name:GIRARD, KATHERINE (DMD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:GIRARD
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 1:1220 MEADOW RD STE 306
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-3670
Mailing Address - Country:US
Mailing Address - Phone:847-272-5400
Mailing Address - Fax:
Practice Address - Street 1:1220 MEADOW RD STE 306
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-3670
Practice Address - Country:US
Practice Address - Phone:847-272-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2025-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL033924122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice