Provider Demographics
NPI:1902309974
Name:GEHRMAN, KATHLEEN ANN (RDH)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ANN
Last Name:GEHRMAN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:ANN
Other - Last Name:FAUGHT GEHRMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:113 WAPPOO CREEK DR. SUITE #5
Mailing Address - Street 2:JAMES ISLAND DENTAL ASSOCIATES
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-2136
Mailing Address - Country:US
Mailing Address - Phone:843-762-1234
Mailing Address - Fax:843-762-9142
Practice Address - Street 1:113 WAPPOO CREEK DR. SUITE #5
Practice Address - Street 2:JAMES ISLAND DENTAL ASSOCIATES
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2136
Practice Address - Country:US
Practice Address - Phone:843-762-1234
Practice Address - Fax:843-762-9142
Is Sole Proprietor?:No
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2990124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist