Kathrina Demecillo Delima, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN0139731 Issued in GA

Practice address

4802 Tenth Avenue
Maimonides Medical Center, Department of Dentistry
Brooklyn, NY 11219

Phone

(718) 283-6000

NPI assigned

Jul 10, 2009

Last updated

Oct 29, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1194954164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 49TH ST APT FF6",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192947",
            "telephone_number": "678-360-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 TENTH AVENUE",
            "address_2": "MAIMONIDES MEDICAL CENTER, DEPARTMENT OF DENTISTRY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219",
            "telephone_number": "718-283-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELIMA",
        "first_name": "KATHRINA",
        "middle_name": "DEMECILLO",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN0139731",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Delice-Maurent, LCSW
• Tracey Delienne, PHD
• Berthain Samuel Delille, RPA-C
• Myrlande Delille, PA
• Stephanie Myrlande Delille
• Wendy Delimeta
• Cathiana Delisca
• Samantha Y Delisca
• Thainah Delisca
• Chanel T. Delisser, OTR/L

• Pediatric Dentistry in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.