Individual provider Active NPI

Cathryne Lee Kionke Harris, D.M.D.

  • Dentist
  • Newark, DE
National Provider Identifier
1356648059
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
G1-0001141 Issued in DE
Practice address
34 West Main Street
Suite 400
Newark, DE 19702
Phone
(302) 453-1400
Fax
(302) 453-9553
NPI assigned
Feb 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X G1-0001141 DE Primary

Addresses

Primary practice location

34 West Main Street
Suite 400
Newark, DE 19702

Mailing address

34 West Main Street
Suite 400
Newark, DE 19702
Phone (302) 453-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20150612002105 DE Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4789995044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1356648059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 WEST MAIN STREET",
            "address_2": "SUITE 400",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19702",
            "telephone_number": "302-453-1400",
            "fax_number": "302-453-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 WEST MAIN STREET",
            "address_2": "SUITE 400",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19702",
            "telephone_number": "302-453-1400",
            "fax_number": "302-453-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CATHRYNE",
        "middle_name": "LEE KIONKE",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-16",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DE",
            "license": "G1-0001141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.