Provider Demographics
NPI:1063530673
Name:KATZ, JEFFREY L (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:L
Last Name:KATZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 VAN NESS AVE STE 2020
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-6310
Mailing Address - Country:US
Mailing Address - Phone:415-776-4133
Mailing Address - Fax:415-776-4333
Practice Address - Street 1:601 VAN NESS AVE STE 2020
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-6310
Practice Address - Country:US
Practice Address - Phone:415-776-4133
Practice Address - Fax:415-776-4333
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA232011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice