NPIMap

Individual provider Active NPI

Kathryn Determan, DDS

  • General Practice Dentistry
  • Balaton, MN
National Provider Identifier
1104348697
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
09399 Issued in IA
Practice address
123 3Rd St (Balaton Dental Clinic)
Balaton, MN 56115
Phone
(507) 734-2251
NPI assigned
Jul 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 09399 IA Primary

Addresses

Primary practice location

123 3Rd St (Balaton Dental Clinic)
Balaton, MN 56115

Mailing address

1621 131St St
Slayton, MN 56172
Phone (612) 270-7573

Other names 1

  • Kathryn Handtke Former name

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

LicenseStateTypeSpecialty
09399IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Richard E Kohler DDS PC Past Accepting new patients
Balaton Dental Clinic,Inc General Practice PastSince Sep 5, 2021 Accepting new patients
Nodaway Valley Dental PLC Past Accepting new patients

Organizations & group practices 3

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": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1104348697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 131ST ST",
            "city": "SLAYTON",
            "state": "MN",
            "postal_code": "56172",
            "telephone_number": "612-270-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 3RD ST (BALATON DENTAL CLINIC)",
            "city": "BALATON",
            "state": "MN",
            "postal_code": "56115",
            "telephone_number": "507-734-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETERMAN",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "09399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "HANDTKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Balaton, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.

Verify at the official NPI Registry.