Provider Demographics
NPI:1316316938
Name:AFFRUNTI, CAITLYN KENDRA (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:CAITLYN
Middle Name:KENDRA
Last Name:AFFRUNTI
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:KENDRA
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:15613 BEL RED RD STE A
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-2348
Mailing Address - Country:US
Mailing Address - Phone:425-883-8333
Mailing Address - Fax:
Practice Address - Street 1:303 BROOKSIDE AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4617
Practice Address - Country:US
Practice Address - Phone:909-793-8837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64861122300000X, 1223P0300X
WADE605176751223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist