Provider Demographics
NPI:1043484918
Name:STIMSON, KATHLEEN MCCLINTOCK (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:MCCLINTOCK
Last Name:STIMSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:MCCLINTOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2780 STATE ST
Mailing Address - Street 2:SUITE EIGHT
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-5518
Mailing Address - Country:US
Mailing Address - Phone:805-687-2434
Mailing Address - Fax:
Practice Address - Street 1:2780 STATE ST
Practice Address - Street 2:SUITE EIGHT
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-5518
Practice Address - Country:US
Practice Address - Phone:805-687-2434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA308981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice