Katie Wesneski Whitworth, DDS
Individual provider Active NPI General Practice Dentistry · Brady, TX
NPI 1003460080 · NPPES record last updated Oct 29, 2020
Key facts
- NPI
- 1003460080
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 35515 (TX)
- Practice address
- 1211 S Bridge St
Brady, TX 76825-6229 - Phone
- (325) 597-0464
- NPI assigned
- Jul 29, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190910000222 | TX | Practitioner - Dentist | 4284963711 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35515 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frontera Healthcare Network | Current |
Accepting new patients | |
| Frontera Healthcare Network | Current | Accepting new patients | |
| Frontera Healthcare Network | Current |
Accepting new patients |
Locations
1211 S Bridge St
Brady, TX 76825
Phone (325) 597-0464
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 35515 | TX | Yes |
Addresses
Primary practice location
1211 S Bridge St
Brady, TX 76825-6229
Mailing address
6595 Ranch Road 385
London, TX 76854-5600
Other providers in Brady, TX
- Rita Nobles Sutton
- Texas Oxycare, Inc.
- Mary Elizabeth Torrez
- Lonnie Lee Vickers
- Wal-Mart Stores Texas LLC
All providers in Brady, TX · General Practice Dentistry in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.