Provider Demographics
NPI:1194988519
Name:KATS, ELINA (DDS)
Entity type:Individual
Prefix:DR
First Name:ELINA
Middle Name:
Last Name:KATS
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 1:9211 35TH AVE APT 1K
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-5844
Mailing Address - Country:US
Mailing Address - Phone:718-426-2231
Mailing Address - Fax:718-426-2232
Practice Address - Street 1:9211 35TH AVE APT 1K
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-5844
Practice Address - Country:US
Practice Address - Phone:718-426-2231
Practice Address - Fax:718-426-2232
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052922-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03079930Medicaid