Provider Demographics
NPI:1295619369
Name:STEPANEK, KATELYN (DDS)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:STEPANEK
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 1:3280 BARNETT AVE APT 2165
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-4292
Mailing Address - Country:US
Mailing Address - Phone:913-709-0073
Mailing Address - Fax:
Practice Address - Street 1:3430 MARRON RD STE 300
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4674
Practice Address - Country:US
Practice Address - Phone:760-730-1303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-02
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111752122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist