Provider Demographics
NPI:1942372453
Name:SWEET, KATRINA K (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:K
Last Name:SWEET
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KATRINA
Other - Middle Name:K
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:9021 S BLACKSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-7909
Mailing Address - Country:US
Mailing Address - Phone:773-398-1413
Mailing Address - Fax:
Practice Address - Street 1:9021 S BLACKSTONE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-7909
Practice Address - Country:US
Practice Address - Phone:773-398-1413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10020461223X0400X
IL021.0030911223X0400X
IN12013584A1223X0400X
IL019-0269321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics