Active NPI
Kathie Sue Allen, DDS
- General Practice Dentistry
- Venice, FL
National Provider Identifier
1255344453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN0013632
- Practice address
- 836 Sunset Lake Blvd
Suite #204
Venice, FL 34292-7556 - Phone
- (941) 492-3211
- Fax
- (941) 492-3212
- NPI assigned
- Aug 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN0013632 | FL | Primary |
Addresses
Primary practice location
836 Sunset Lake Blvd
Suite #204
Venice, FL 34292-7556
Mailing address
836 Sunset Lake Blvd
Suite #204 Lakeside Medical Center
Venice, FL 34292-7556
Phone (941) 492-3211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150701000910 | FL | Order and Referring Only - Dentist | 4486966629 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN0013632 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255344453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "836 SUNSET LAKE BLVD",
"address_2": "SUITE #204 LAKESIDE MEDICAL CENTER",
"city": "VENICE",
"state": "FL",
"postal_code": "342927556",
"telephone_number": "941-492-3211",
"fax_number": "941-492-3212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "836 SUNSET LAKE BLVD",
"address_2": "SUITE #204",
"city": "VENICE",
"state": "FL",
"postal_code": "342927556",
"telephone_number": "941-492-3211",
"fax_number": "941-492-3212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "KATHIE",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN0013632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venice, FL
- All Phase Medical Supplies, LLC
- All Smiles Adult Day Care Center
- All Smiles Senior & Adult Day Care Center
- Allen M Lifton M D P a
- Allen M. Lifton, MD, PA
- Allheart Healthcare, Inc
- Amanda Allyn, APRN
- Yaimy Alonso, ARNP
- Jacqueline Resto Alpaugh, LMT
- Alternative Homemaking With a Heart of SW Florida LLC
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.