Mary Kathryn Deloach, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

016.0095505 Issued in VT

Practice address

60 Timber LN
South Burlington, VT 05403-7214

Phone

(802) 864-6881

NPI assigned

Apr 1, 2012

Last updated

May 30, 2013By 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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Timberlane Dental Associates, PLC

  • Dentist
  • South Burlington, VT
  • NPI 1922841329
  NPD (past)

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

{
    "created_epoch": "1333238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1235405424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 EASTWOOD DR",
            "address_2": "309",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034497",
            "telephone_number": "203-623-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 TIMBER LN",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037214",
            "telephone_number": "802-864-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELOACH",
        "first_name": "MARY KATHRYN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-01",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "016.0095505",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dee Physical Therapy Services PLC
• Justine McCuen Dee, PT, MS
• Michael Christopher Dee, PT
• Denis D Dees, MA LADC NCACII
• Grigorios Delaportas, P.A.
• Elissa Ann Delong, WHNP-BC
• Alex Robert Denny, PT, DPT, CSCS
• Jessica Elissa Denton, LICSW
• Danielle Mavis Desroche, ND
• Megan Detweiler, RN

• General Practice Dentistry in South Burlington, VT
• Providers in South Burlington, VT by specialty
• General Practice Dentistry in Vermont

• 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.