Provider Demographics
NPI:1790429645
Name:SINCLAIR, KATELYN A (DMD)
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:A
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1767 PRINCESS ANNE RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-3835
Mailing Address - Country:US
Mailing Address - Phone:757-426-6151
Mailing Address - Fax:757-426-6235
Practice Address - Street 1:1767 PRINCESS ANNE RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-3835
Practice Address - Country:US
Practice Address - Phone:757-426-6151
Practice Address - Fax:757-426-6235
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014178631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice