Provider Demographics
NPI:1699356949
Name:KATZ, RENA (DDS)
Entity type:Individual
Prefix:
First Name:RENA
Middle Name:
Last Name:KATZ
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 1:3935 BLACKSTONE AVE APT 6F
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3719
Mailing Address - Country:US
Mailing Address - Phone:718-309-8644
Mailing Address - Fax:
Practice Address - Street 1:701 N BROADWAY
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1096
Practice Address - Country:US
Practice Address - Phone:914-366-3590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062674122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist