Active NPI
Katherine Burkett, DDS
- Dentist
- Columbus, IN
National Provider Identifier
1033788153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12013642A
- Practice address
- 530 Plaza Dr Ste J
Columbus, IN 47201-2940 - Phone
- (812) 376-9335
- NPI assigned
- Jun 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12013642A | IN | Primary |
Addresses
Primary practice location
530 Plaza Dr Ste J
Columbus, IN 47201-2940
Mailing address
4526 Woodland Dr
Indianapolis, IN 46254-2093
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12013642A | IN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adam D. Clock, D.D.S., L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Columbus, IN
- NPI 1265662217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1033788153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4526 WOODLAND DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462542093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 PLAZA DR STE J",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "472012940",
"telephone_number": "812-376-9335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKETT",
"first_name": "KATHERINE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-22",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12013642A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.