Individual provider Active NPI

Kelly Erin Willhite, D.D.S.

  • General Practice Dentistry
  • Rising Sun, IN
National Provider Identifier
1205840949
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009380 Issued in IN
Practice address
303 Industrial Access Rd
Rising Sun, IN 47040-8915
Phone
(812) 438-2500
Fax
(812) 438-2591
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12009380 IN Primary

Addresses

Primary practice location

303 Industrial Access Rd
Rising Sun, IN 47040-8915

Mailing address

303 Industrial Access Rd
Rising Sun, IN 47040-8915
Phone (812) 438-2500

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
12009380INMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205840949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 INDUSTRIAL ACCESS RD",
            "city": "RISING SUN",
            "state": "IN",
            "postal_code": "470408915",
            "telephone_number": "812-438-2500",
            "fax_number": "812-438-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 INDUSTRIAL ACCESS RD",
            "city": "RISING SUN",
            "state": "IN",
            "postal_code": "470408915",
            "telephone_number": "812-438-2500",
            "fax_number": "812-438-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLHITE",
        "first_name": "KELLY",
        "middle_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rising Sun, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.