Kathryn J Sudikoff DMD PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KATHRYN J SUDIKOFF DMD PLLC

Practice address

1315 East Blvd
Charlotte, NC 28203-5975

Phone

(704) 632-9922

NPI assigned

Nov 28, 2023

Last updated

Nov 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathryn SudikoffNPI 1265452478

Title

Owner

Phone

(704) 632-9922

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathryn Jane Sudikoff, DMD

  • General Practice Dentistry
  • Charlotte, NC
  • NPI 1265452478
  NPD Authorized official
• Edward I Shapiro, D.D.S

  • General Practice Dentistry
  • Charlotte, NC
  • NPI 1790707917
  NPD (past)

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1225804677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 EAST BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035975",
            "telephone_number": "704-332-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 EAST BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035975",
            "telephone_number": "704-632-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHRYN J SUDIKOFF DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "SUDIKOFF",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-632-9922"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shilpa Kasuganti
• Smita Kataria, MPT
• Rutvi Chetankumar Katariya, MD
• Andrew Katerakis, DDS
• Katherine S Pak, DDS PLLC
• Kathyrn D. Jendrasik-Savitsky, DMD, PA
• William G. Katibah III, M.D.
• Katie Blessing Center, LLC
• Katie Kickertz DDS Ms PLLC (Premier Endodontics of SouthPark)
• Ava Rose Katinas

• Dental Clinic/Center in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Dental Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.