Individual provider · Type 1 NPI

Kathleen Elissa Wirth, DMD

Student in an Organized Health Care Education/Training Program · Fort Lauderdale, FL

NPI number 1700717048 Active

Practice location

824 NE 19th Ave
Fort Lauderdale, FL 33304-3081

Call (304) 303-3020 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1700717048

Kathleen Elissa Wirth, DMD's National Provider Identifier is 1700717048, issued on May 26, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fort Lauderdale, FL. The record was last updated on May 26, 2026.