Individual provider Active NPI

Eric A Katkow, D.D.S

  • General Practice Dentistry
  • Columbia, MD
National Provider Identifier
1336153394
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4823 Issued in MD
Practice address
8600 Snowden River Pkwy
#106
Columbia, MD 21045-1982
Phone
(410) 730-2020
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4823 MD Primary

Addresses

Primary practice location

8600 Snowden River Pkwy
#106
Columbia, MD 21045-1982

Mailing address

8600 Snowden River Pkwy
#106
Columbia, MD 21045-1982
Phone (410) 730-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151201000004 MD Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 4981904752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4823MDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336153394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 SNOWDEN RIVER PKWY",
            "address_2": "#106",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210451982",
            "telephone_number": "410-730-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 SNOWDEN RIVER PKWY",
            "address_2": "#106",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210451982",
            "telephone_number": "410-730-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATKOW",
        "first_name": "ERIC",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "4823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.