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Kelly Mika Katsura
Pediatric Dentist in Berkeley, California
NPI 1598340622

Kelly Mika Katsura is a Pediatric Dentist based in Waianae, CA and is specialized in Pediatric Dentistry. Kelly Mika Katsura practices in Berkeley, CA. The NPI Number for Kelly Mika Katsura is 1598340622 and holds a License No. (California).

The current practice location address for Kelly Mika Katsura is 2640 Telegraph Ave, Berkeley, CA and can be reached out via phone at 510-848-6494.

Location: 2640 Telegraph Ave, Berkeley, CA, 96792-3128
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1598340622
Provider Name
Kelly Mika Katsura
Credential
Provider Entity Type
Individual
Gender
Female
Address
2640 Telegraph Ave, Berkeley, CA, 96792-3128
Phone Number
510-848-6494
Fax Number
Provider Enumeration Date
03/10/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2640 Telegraph Ave
City
Berkeley
State
California
Zip
94704-3374
Phone Number
510-848-6494
Fax Number
person
Provider Business Mailing Address Details
Address
2640 Telegraph Ave
City
Berkeley
State
California
Zip
94704-3374
Phone Number
510-848-6494
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
DDS107420 (California)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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