Provider Demographics
NPI:1063591501
Name:MULCAHEY, KATHLEEN L (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:L
Last Name:MULCAHEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27885 SMYTH DR
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4011
Mailing Address - Country:US
Mailing Address - Phone:661-294-1800
Mailing Address - Fax:661-294-9774
Practice Address - Street 1:27885 SMYTH DR
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4011
Practice Address - Country:US
Practice Address - Phone:661-294-1800
Practice Address - Fax:661-294-9774
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA412871223P0221X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics