NPIMap

Individual provider Active NPI

Karen Louise Robertson, R.D.H.

  • Dental Hygienist
  • New London, CT
National Provider Identifier
1174960223
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
007205 Issued in CT
Practice address
15 Mohegan Ave
New London, CT 06320-8100
Phone
(860) 444-8424
NPI assigned
May 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 007205 CT Primary

Addresses

Primary practice location

15 Mohegan Ave
New London, CT 06320-8100

Mailing address

15 Mohegan Ave
New London, CT 06320-8100
Phone (860) 444-8424

Other names 1

  • Karen Louise Kalisek 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
007205CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1174960223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MOHEGAN AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063208100",
            "telephone_number": "860-444-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MOHEGAN AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063208100",
            "telephone_number": "860-444-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KAREN",
        "middle_name": "LOUISE",
        "credential": "R.D.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CT",
            "license": "007205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "KALISEK",
            "middle_name": "LOUISE",
            "credential": "R.D.H.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; 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.