Individual provider Active NPI

Katelyn Tomlin, DDS

  • General Practice Dentistry
  • Beckley, WV
National Provider Identifier
1396632444
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4784 Issued in WV
Practice address
102 Galleria PLZ
Beckley, WV 25801-3162
Phone
(681) 207-7063
NPI assigned
Jun 20, 2025
Last updated
Jun 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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 4784 WV Primary

Addresses

Primary practice location

102 Galleria PLZ
Beckley, WV 25801-3162

Mailing address

102 Galleria PLZ
Beckley, WV 25801-3162
Phone (681) 207-7063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20260324000344 WV Practitioner - Dentist 7911481429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
West Virginia University School of Dentistry, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

497 Mall Rd
Oak Hill, WV 25901-6115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4784WVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Dental Centers General Practice PastSince Jun 23, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1396632444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 GALLERIA PLZ",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013162",
            "telephone_number": "681-207-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 GALLERIA PLZ",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013162",
            "telephone_number": "681-207-7063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMLIN",
        "first_name": "KATELYN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "4784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

Verify at the official NPI Registry.