Katharine Joleen Pins, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

08419 Issued in IA

Practice address

100 S 4TH Avenue
Unit 2
Eldridge, IA 52748

Phone

(563) 285-5600

Fax

(563) 296-5622

NPI assigned

Jan 29, 2007

Last updated

Jul 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1013053891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S 4TH AVENUE",
            "address_2": "UNIT 2",
            "city": "ELDRIDGE",
            "state": "IA",
            "postal_code": "52748",
            "telephone_number": "563-285-5600",
            "fax_number": "563-296-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S 4TH AVENUE",
            "address_2": "UNIT 2",
            "city": "ELDRIDGE",
            "state": "IA",
            "postal_code": "52748",
            "telephone_number": "563-285-5600",
            "fax_number": "563-296-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINS",
        "first_name": "KATHARINE",
        "middle_name": "JOLEEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0498063",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Eldridge, IA
• Providers in Eldridge, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.