Provider Demographics
NPI:1073249066
Name:TRIESCHMAN, KATE EATON (DMD)
Entity type:Individual
Prefix:DR
First Name:KATE
Middle Name:EATON
Last Name:TRIESCHMAN
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 1:5701 E 8TH AVE APT 300
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4510
Mailing Address - Country:US
Mailing Address - Phone:978-505-8183
Mailing Address - Fax:
Practice Address - Street 1:3545 QUEBEC ST STE 110
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-1603
Practice Address - Country:US
Practice Address - Phone:720-465-7957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODEN.002058621223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program