Katherine Quist, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

35648 Issued in CA

Practice address

1206 The Alameda
Berkeley, CA 94709-1907

Phone

(510) 525-7521

Fax

(510) 525-5262

NPI assigned

Mar 5, 2007

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356470496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 THE ALAMEDA",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091907",
            "telephone_number": "510-525-7521",
            "fax_number": "510-525-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 THE ALAMEDA",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091907",
            "telephone_number": "510-525-7521",
            "fax_number": "510-525-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIST",
        "first_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "35648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LIC #",
            "identifier": "35648",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Arva Danielle Rackley
• Susan Delaney Raeburn, PH.D.
• Lisa Hoel Rafael, RBT

• Dentist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Dentist in California

• 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.

Verify at the official NPI Registry.