Individual provider Active NPI

Kristin Yoshiko Dattoria, SLP

  • Speech-Language Pathologist
  • Ashburn, VA
National Provider Identifier
1326645722
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
20130 Lakeview Center PLZ Ste 400
Ashburn, VA 20147-5905
Phone
(847) 751-0045
NPI assigned
Oct 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X MD Primary

Addresses

Primary practice location

20130 Lakeview Center PLZ Ste 400
Ashburn, VA 20147-5905

Mailing address

2741 Loch Haven Dr
Ijamsville, MD 21754-8815
Phone (661) 618-0861

Other practice location 1

1305 Dares Beach Rd
Prince Frederick, MD 20678-4208
Phone (443) 550-8345

Other names 1

  • Kristin Yoshiko Ladd Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250107001230 VA Practitioner - Qualified Speech Language Pathologist 1658809520 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hona Medical Group PA Speech-Language Pathologist CurrentSince Nov 25, 2024 Accepting new patients

Locations

6303 Waterford District Dr
Ste 400
Miami, FL 33126
Phone (786) 801-1571

20130 Lakeview Center Plz
Ste 400
Ashburn, VA 20147
Phone (700) 865-2144

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1326645722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2741 LOCH HAVEN DR",
            "city": "IJAMSVILLE",
            "state": "MD",
            "postal_code": "217548815",
            "telephone_number": "661-618-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20130 LAKEVIEW CENTER PLZ STE 400",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475905",
            "telephone_number": "847-751-0045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1305 Dares Beach Rd",
            "address_purpose": "LOCATION",
            "city": "Prince Frederick",
            "state": "MD",
            "postal_code": "206784208",
            "country_code": "US",
            "telephone_number": "443-550-8345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DATTORIA",
        "first_name": "KRISTIN",
        "middle_name": "YOSHIKO",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "LADD",
            "middle_name": "YOSHIKO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.