Provider Demographics
NPI:1457958928
Name:KATARYA, EESHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:EESHA
Middle Name:
Last Name:KATARYA
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 1:5955 SHETLAND DR NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-3739
Mailing Address - Country:US
Mailing Address - Phone:507-250-6569
Mailing Address - Fax:
Practice Address - Street 1:18 3RD ST SW STE 300
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-3022
Practice Address - Country:US
Practice Address - Phone:507-258-5260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND148651223G0001X
AZD0108651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice