Individual provider Active NPI

Katherine Alexis Yale

  • Dentist
  • Oxnard, CA
National Provider Identifier
1073403085
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS111660 Issued in CA
Practice address
1381 W Channel Islands Blvd
Oxnard, CA 93033-4203
Phone
(805) 253-1796
NPI assigned
Jul 9, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS111660 CA Primary

Addresses

Primary practice location

1381 W Channel Islands Blvd
Oxnard, CA 93033-4203

Mailing address

10316 Mason Ave
Chatsworth, CA 91311-3305

Other practice location 1

10316 Mason Ave
Chatsworth, CA 91311-3305
Phone (818) 493-1302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20251009003038 CA Order and Referring Only - DentistPractitioner - Dentist 8123525607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS111660CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Yeaton and Mar Dental Corporation Dentist PastSince Jul 13, 2025 Accepting new patients
Joseph Hanna DDS Inc Dentist PastSince Jul 13, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1073403085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10316 MASON AVE",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913113305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1381 W CHANNEL ISLANDS BLVD",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930334203",
            "telephone_number": "805-253-1796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10316 Mason Ave",
            "address_purpose": "LOCATION",
            "city": "Chatsworth",
            "state": "CA",
            "postal_code": "913113305",
            "country_code": "US",
            "telephone_number": "818-493-1302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YALE",
        "first_name": "KATHERINE",
        "middle_name": "ALEXIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS111660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.