Individual provider Active NPI

Katherine Mudd, D.M.D.

  • General Practice Dentistry
  • Columbus, OH
National Provider Identifier
1003215989
Registry record updated Aug 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-024247 Issued in OH
Practice address
17 N Harding Rd
Columbus, OH 43209-1583
Phone
(614) 239-0051
NPI assigned
Aug 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30-024247 OH Primary

Addresses

Primary practice location

17 N Harding Rd
Columbus, OH 43209-1583

Mailing address

236 Lansing St
Columbus, OH 43206-2659
Phone (502) 507-1671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150505000684 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0345569802

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-024247OHMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408233600000",
    "number": "1003215989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 LANSING ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432062659",
            "telephone_number": "502-507-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 N HARDING RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432091583",
            "telephone_number": "614-239-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDD",
        "first_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-17",
        "last_updated": "2014-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-024247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.