Kathleen Poole, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

10115 Issued in AZ

Practice address

6524 W Indian School Rd Ste a
Phoenix, AZ 85033-3329

Phone

(623) 428-2400

Fax

(623) 777-4120

NPI assigned

Feb 18, 2015

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

Medicare fee-for-service enrollment

Enrolled in AZ

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

Practice roles

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.

• Navajo Health Foundation-Sage Memorial Hospital, Inc.

  • Rural Acute Care Hospital
  • Ganado, AZ
  • NPI 1477735777
  Medicare reassignment NPD
• Navajo Health Foundation-Sage Memorial Hospital Inc

  • Critical Access Hospital Clinic/Center
  • Ganado, AZ
  • NPI 1518957398
  NPD
• Sonrisas

  • Dentist
  • Phoenix, AZ
  • NPI 1003397761
  NPD (past)

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564185600000",
    "number": "1356733992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 358",
            "city": "CROWNPOINT",
            "state": "NM",
            "postal_code": "873130358",
            "telephone_number": "505-786-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6524 W INDIAN SCHOOL RD STE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850333329",
            "telephone_number": "623-428-2400",
            "fax_number": "623-777-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2019-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "10115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig W. Pool, D.D.S.
• Brittany Poole, LCSW
• Bryan Kevin Poole, RN
• Cambra Poole
• Eric L Poole, D.C.
• Lovely Poole, LMSW
• Marie Poonawala, MS, OTR/L
• Maria Pop
• Sorana Liana Pop, FNP
• Otilia Popa

• Dentist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2019; 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.