Individual provider Active NPI

Kaitlin C Small, D.M.D.

  • Dentist
  • Lawrenceville, NJ
National Provider Identifier
1386765741
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02127600 Issued in NJ
Practice address
133 Franklin Corner Rd
Lawrenceville, NJ 08648-2531
Phone
(609) 896-0529
Fax
(609) 895-1236
NPI assigned
Apr 3, 2007
Sex
Female
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
Dentist 122300000X 22DI02127600 NJ Primary

Addresses

Primary practice location

133 Franklin Corner Rd
Lawrenceville, NJ 08648-2531

Mailing address

133 Franklin Corner Rd
Lawrenceville, NJ 08648-2531
Phone (609) 896-0529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Sep 24, 2015 through Sep 24, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22DI02127600NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386765741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 FRANKLIN CORNER RD",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482531",
            "telephone_number": "609-896-0529",
            "fax_number": "609-895-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 FRANKLIN CORNER RD",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482531",
            "telephone_number": "609-896-0529",
            "fax_number": "609-895-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "KAITLIN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02127600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

Verify at the official NPI Registry.