1558463828 NPI number — DR. KATHLEEN NONE MCNALLY D.D.S.

Table of content: DR. KATHLEEN NONE MCNALLY D.D.S. (NPI 1558463828)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558463828 NPI number — DR. KATHLEEN NONE MCNALLY D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCNALLY
Provider First Name:
KATHLEEN
Provider Middle Name:
NONE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558463828
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8901 WISCONSIN AVENUE BLDG 2, 3RD FLOOR, RM 3262
Provider Second Line Business Mailing Address:
NAVAL POST GRADUATE SCHOOL
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20889
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-319-8740
Provider Business Mailing Address Fax Number:
301-295-9301

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8901 WISCONSIN AVENUE BLDG 2, 3RD FLOOR, RM 3262
Provider Second Line Business Practice Location Address:
NAVAL POST GRADUATE SCHOOL
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20889
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-319-8740
Provider Business Practice Location Address Fax Number:
301-295-9301
Provider Enumeration Date:
09/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223E0200X , with the licence number:  11136 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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