Katy Dental, Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

019024012 Issued in IL

Legal business name

KATY DENTAL, INC.

Practice address

3510 Hobson Rd
Suite 302
Woodridge, IL 60517-1439

Phone

(630) 971-3626

Fax

(630) 971-3752

NPI assigned

Aug 13, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Martha Catalina Villasenor, D.D.S.

Title

Owner

Phone

(708) 601-5081

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1285067298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 HOBSON RD",
            "address_2": "SUITE 302",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605171439",
            "telephone_number": "630-971-3626",
            "fax_number": "630-971-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 HOBSON RD",
            "address_2": "SUITE 302",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605171439",
            "telephone_number": "630-971-3626",
            "fax_number": "630-971-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATY DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "VILLASENOR",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "CATALINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-601-5081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "IL",
            "license": "019024012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019024012",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brigit B Karimkuttyil, BSN, IBCLC, MSN-FNPC
• Daiva Valeria Karuza, LCPC
• Amy Rose Leping Kaschner, DPT, PT
• Esha Afreen Kasmani, MD
• Barbara Kattke, PHARMD
• Helena Ann Keag, MD
• Michael Maurice Keigher, LCSW
• Ashley M Kershner, DPT
• Briana Kesterson, LCSW
• Mike Kett, M.S., P.T.

• Health Maintenance Organization in Woodridge, IL
• Providers in Woodridge, IL by specialty
• Health Maintenance Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.