Katherine a. Decolibus, DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7389 Issued in TN

Legal business name

KATHERINE A. DECOLIBUS, DDS PLLC

Practice address

4132 Poplar Ave
Memphis, TN 38117-3618

Phone

(901) 680-0377

Fax

(901) 680-0377

NPI assigned

Apr 4, 2008

Last updated

Apr 4, 2008By 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

Katherine DecolibusNPI 1124037379

Title

Owner

Phone

(901) 680-0377

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Katherine Anne Decolibus, DDS

  • General Practice Dentistry
  • Bolivar, TN
  • NPI 1124037379
  NPD (past) Authorized official
• Thomas Cross Coleman, O.D.

  • Optometrist
  • Memphis, TN
  • NPI 1215070628
  NPD (past)

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1245403708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4132 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381173618",
            "telephone_number": "901-680-0377",
            "fax_number": "901-680-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4132 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381173618",
            "telephone_number": "901-680-0377",
            "fax_number": "901-680-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHERINE A. DECOLIBUS, DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "DECOLIBUS",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-680-0377"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214726",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anjan Katel, M.D.
• Melissa Anne Kath, MD
• Ahsan H Kathawala, M.D.
• Arifa Kathawala, M.D.
• Emrose Kathawala
• Kathryn Byrd,MD,PC.
• Morgan Fretwell Kato, MD
• Mark Katras, NP
• Kattrx Pharmacy, LLC
• Allan Jacob Katz, LPC MHSP

• General Practice Dentistry in Memphis, TN
• Providers in Memphis, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; 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.