Provider Demographics
NPI:1881482362
Name:JIMENEZ, KATHERINE AMANDA (DDS)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:AMANDA
Last Name:JIMENEZ
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 ELMHURST CIR
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-2958
Mailing Address - Country:US
Mailing Address - Phone:909-938-4135
Mailing Address - Fax:
Practice Address - Street 1:923 N MILPAS ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-2331
Practice Address - Country:US
Practice Address - Phone:805-884-1998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program