Individual provider Active NPI

Kathleen O'Hara Corbin, DDS

  • Pediatric Dentistry
  • Zachary, LA
National Provider Identifier
1154855526
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
6810 Issued in LA
Practice address
1515 Church St
Zachary, LA 70791-2748
Phone
(225) 654-7760
NPI assigned
Apr 12, 2017
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 6810 LA Primary

Addresses

Primary practice location

1515 Church St
Zachary, LA 70791-2748

Mailing address

1515 Church St
Zachary, LA 70791-2748
Phone (225) 654-7760

Other practice location 1

245 Veterans Blvd
Denham Springs, LA 70726-4720
Phone (225) 664-2646

Other practice location 2

1935 Medical District Dr
Dallas, TX 75235-7701
Phone (214) 456-2735

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
6810LAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Parish Pediatric Dental Krewe Pediatric Dentistry CurrentSince Sep 29, 2024 Accepting new patients
Joseph a. Yale, DDS, LLC Pediatric Dentistry PastSince Jul 25, 2019 Accepting new patients

Locations

1515 Church St
Zachary, LA 70791
Phone (225) 485-4122

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1154855526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 CHURCH ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707912748",
            "telephone_number": "225-654-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 CHURCH ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707912748",
            "telephone_number": "225-654-7760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Veterans Blvd",
            "address_purpose": "LOCATION",
            "city": "Denham Springs",
            "state": "LA",
            "postal_code": "707264720",
            "country_code": "US",
            "telephone_number": "225-664-2646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1935 Medical District Dr",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752357701",
            "country_code": "US",
            "telephone_number": "214-456-2735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORBIN",
        "first_name": "KATHLEEN",
        "middle_name": "O'HARA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "LA",
            "license": "6810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zachary, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.