Individual provider Active NPI

Cathy Dawn Whittern, DDS

  • General Practice Dentistry
  • Longmont, CO
National Provider Identifier
1124142005
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6592 Issued in CO
Practice address
13876 Elmore Rd
Longmont, CO 80504-9309
Phone
(303) 678-7558
Fax
(303) 678-8422
NPI assigned
Mar 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6592 CO Primary
General Practice Dentistry 1223G0001X 10089 MN
General Practice Dentistry 1223G0001X 7232 IA

Addresses

Primary practice location

13876 Elmore Rd
Longmont, CO 80504-9309

Mailing address

13876 Elmore Rd
Longmont, CO 80504-9309
Phone (303) 678-7558

Other names 1

  • Dr. Cathy Dawn Stephenson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20150619001150 CO Order and Referring Only - DentistPractitioner - Dentist 1759692510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7232IAMDGeneral Practice Dentistry
10089MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Aspects PC General Practice 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.

NPI Registry JSON

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

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124142005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13876 ELMORE RD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805049309",
            "telephone_number": "303-678-7558",
            "fax_number": "303-678-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13876 ELMORE RD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805049309",
            "telephone_number": "303-678-7558",
            "fax_number": "303-678-8422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTERN",
        "first_name": "CATHY",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "6592",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "10089",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7232",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHY",
            "last_name": "STEPHENSON",
            "middle_name": "DAWN",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.