NPIMap

Organization Active NPI

Ketchers' Dental PLLC

  • General Practice Dentistry
  • Shelton, WA
National Provider Identifier
1063553014
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE9709 Issued in WA
Legal business name
KETCHERS' DENTAL PLLC
Practice address
1829 Jefferson St
Shelton, WA 98584-2004
Phone
(360) 426-8401
Fax
(360) 426-1427
NPI assigned
Feb 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Authorized official

Name
Dr. Katherine J. Ketcher, DMDNPI 1427022326
Title
Member
Phone
(360) 426-8401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DE9709 WA Primary

Addresses

Primary practice location

1829 Jefferson St
Shelton, WA 98584-2004

Mailing address

1829 Jefferson St
Shelton, WA 98584-2004
Phone (360) 426-8401

Other names 1

  • Shelton Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

1829 Jefferson St
Shelton, WA 98584
Phone (360) 426-8401

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365638400000",
    "number": "1063553014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 JEFFERSON ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842004",
            "telephone_number": "360-426-8401",
            "fax_number": "360-426-1427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 JEFFERSON ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842004",
            "telephone_number": "360-426-8401",
            "fax_number": "360-426-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETCHERS' DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-11",
        "last_updated": "2013-04-11",
        "status": "A",
        "authorized_official_last_name": "KETCHER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "360-426-8401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE9709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelton Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.