Provider Demographics
NPI:1982043204
Name:KASTENS, COURTNEY ALLYSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:ALLYSON
Last Name:KASTENS
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 1:1515 CANDLELIGHT LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-1821
Mailing Address - Country:US
Mailing Address - Phone:720-840-9026
Mailing Address - Fax:
Practice Address - Street 1:22777 SPRINGWOODS VILLAGE PKWY # N2
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-1425
Practice Address - Country:US
Practice Address - Phone:281-227-6453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX347961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO69815551Medicaid