Individual provider Active NPI

Katherine Anne Reardon, DDS

  • Dentist
  • Sioux Falls, SD
National Provider Identifier
1124330725
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D0950 Issued in SD
Practice address
3305 S Lincoln Ave
Sioux Falls, SD 57105-5224
Phone
(605) 336-8144
Fax
(605) 335-3568
NPI assigned
Jul 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D0950 SD Primary

Addresses

Primary practice location

3305 S Lincoln Ave
Sioux Falls, SD 57105-5224

Mailing address

3305 S Lincoln Ave
Sioux Falls, SD 57105-5224
Phone (605) 336-8144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20150709000054 SD Order and Referring Only - DentistPractitioner - Dentist 6002128766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reardon Dental Health 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": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1124330725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 S LINCOLN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571055224",
            "telephone_number": "605-336-8144",
            "fax_number": "605-335-3568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 S LINCOLN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571055224",
            "telephone_number": "605-336-8144",
            "fax_number": "605-335-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-12",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SD",
            "license": "D0950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.