Provider Demographics
NPI:1568027407
Name:VERRELLI, KAITLYN PARKMAN (DDS)
Entity type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:PARKMAN
Last Name:VERRELLI
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 1:9003 ASHCROFT WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-4900
Mailing Address - Country:US
Mailing Address - Phone:757-635-7469
Mailing Address - Fax:
Practice Address - Street 1:11124 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4712
Practice Address - Country:US
Practice Address - Phone:804-893-5079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
VA04014167777122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program