Provider Demographics
NPI:1154950921
Name:CATALUNA, ANDRE KLAY (DDS)
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:KLAY
Last Name:CATALUNA
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 1:22608 MARBELLA AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-3921
Mailing Address - Country:US
Mailing Address - Phone:310-505-8485
Mailing Address - Fax:
Practice Address - Street 1:152 S LASKY DR STE 204
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-1716
Practice Address - Country:US
Practice Address - Phone:310-276-7028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1061231223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics