Provider Demographics
NPI:1962232710
Name:STEINHOFF, KATLYN ALYSSA
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:ALYSSA
Last Name:STEINHOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATLYN
Other - Middle Name:ALYSSA
Other - Last Name:BRIGHTWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6931 MANDAN DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80925-8457
Mailing Address - Country:US
Mailing Address - Phone:912-438-1311
Mailing Address - Fax:
Practice Address - Street 1:8580 SCARBOROUGH DR STE 105
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7583
Practice Address - Country:US
Practice Address - Phone:719-528-5577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127626126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant