Katelyn Cantrell

Primary specialty

DentistTaxonomy code 122300000X

License

0401417968 Issued in VA

Practice address

1215 Lee St
Mail Stop 800740
Charlottesville, VA 22908-0816

Phone

(434) 924-1774

Fax

(434) 243-6378

NPI assigned

Mar 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Charlottesville Blue Ridge Dental, PLC

  • General Practice Dentistry
  • Charlottesville, VA
  • NPI 1538849880
  NPD

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1417534660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 COMMONWEALTH DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229011622",
            "telephone_number": "434-978-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "address_2": "MAIL STOP 800740",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-1774",
            "fax_number": "434-243-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew J Canning, LCSW
• Kellie Cannon, LPC, MA, NCC
• Tikara Shauneice Cannon, CBS, IBCLC
• Zachary Canova, PT
• Randolph J. Canterbury, M.D.
• Leigh A. Cantrell, M.D., MSPH
• Joe Anthony Cantu, D.C.
• Linda Ann Capacchione, L.P.C.
• Magen Caplinger
• Mark A Caplinger, DPT

• Dentist in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.