Provider Demographics
NPI:1861508947
Name:KATZ, ABRAHAM A (DDS)
Entity Type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:A
Last Name:KATZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 ELDEN ST
Mailing Address - Street 2:SUITE 15
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4868
Mailing Address - Country:US
Mailing Address - Phone:703-478-9574
Mailing Address - Fax:703-478-0671
Practice Address - Street 1:102 ELDEN ST
Practice Address - Street 2:SUITE 15
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4868
Practice Address - Country:US
Practice Address - Phone:703-478-9574
Practice Address - Fax:703-478-0671
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401006001122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist