Provider Demographics
NPI:1750975439
Name:BELLANT, KATHLEEN ANN (RDHAP, OMT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:BELLANT
Suffix:
Gender:F
Credentials:RDHAP, OMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 PEGER RD STE 210
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-5484
Mailing Address - Country:US
Mailing Address - Phone:907-947-4696
Mailing Address - Fax:833-744-0046
Practice Address - Street 1:3180 PEGER RD STE 210
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-5484
Practice Address - Country:US
Practice Address - Phone:907-947-4696
Practice Address - Fax:833-744-0046
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKDENH2014124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist