Kathleen Odell, DDS, MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

143309-9923 Issued in UT

Practice address

826 E 12300 S Ste 2
Draper, UT 84020-8276

Phone

(801) 571-8821

Fax

(801) 998-8810

NPI assigned

May 7, 2007

Last updated

Sep 7, 2017By 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

Other names 1

• Kathleen McCombs Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• UT PPO D-SNP

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504742400000",
    "number": "1255544599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5349 HOLLADAY BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84117",
            "telephone_number": "801-856-8511",
            "fax_number": "801-998-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 E 12300 S STE 2",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208276",
            "telephone_number": "801-571-8821",
            "fax_number": "801-998-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODELL",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2017-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE60413286",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "UT",
            "license": "143309-9923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "MCCOMBS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brooke O'Brien, FNP-C
• Caitlin M O'Brien, DPT
• Robin Lynn O'Dell, AMFT/SUD-C
• Austin Oborn, PHARMD
• Occupational Health Centers of the Southwest, P.a. (Ut) (Concentra Medical Center)
• Claire Odle
• Stephanie Ogden
• Natasha Ogle
• Adedoyin Ojo
• Angela Okonye, DPT

• Periodontics in Draper, UT
• Providers in Draper, UT by specialty
• Periodontics in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; 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.