Individual provider Active NPI

Kathleen Hood, D.D.S.

  • Dentist
  • Niceville, FL
National Provider Identifier
1174903470
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN23815 Issued in FL
Practice address
4579 E Highway 20 Ste 210
Niceville, FL 32578-9810
Phone
(850) 897-4200
NPI assigned
Jun 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN23815 FL Primary

Addresses

Primary practice location

4579 E Highway 20 Ste 210
Niceville, FL 32578-9810

Mailing address

4579 E Highway 20 Ste 210
Niceville, FL 32578-9810
Phone (850) 897-4200

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN23815FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Midbay Dental PPLC Dentist CurrentSince Jan 14, 2024 Accepting new patients
Mid Bay Dental PLLC CurrentSince Jan 14, 2024 Accepting new patients
Samir K. Hanna & Associates, P.a. PastSince Jul 24, 2022 Accepting new patients

Locations

4579 E Highway 20
Ste 210
Niceville, FL 32578
Phone (850) 897-4200

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": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1174903470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4579 E HIGHWAY 20 STE 210",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325789810",
            "telephone_number": "850-897-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4579 E HIGHWAY 20 STE 210",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325789810",
            "telephone_number": "850-897-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOD",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.