Provider Demographics
NPI:1053403816
Name:REARDEN, CATHY L (DDS)
Entity type:Individual
Prefix:DR
First Name:CATHY
Middle Name:L
Last Name:REARDEN
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 1:2346 CEDAR ROAD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323
Mailing Address - Country:US
Mailing Address - Phone:757-558-1252
Mailing Address - Fax:
Practice Address - Street 1:2346 CEDAR ROAD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323
Practice Address - Country:US
Practice Address - Phone:757-558-1252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010069621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice