Katharina S Fung, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

019032168 Issued in IL

Practice address

2125 Green Vista Dr Ste 104
Sparks, NV 89431-8515

Phone

(775) 674-1444

Fax

(775) 674-1515

NPI assigned

Jun 24, 2016

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

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 Aug 12, 2019 through Aug 12, 2027

Medicare enrollment (NPD)

Not 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.

• Rutkowski & Fung, DDS, DMD, PLLC

  dba The Smile Studio

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Sparks, NV
  • NPI 1386468403
  NPD
• Kevin J Andrews DDS Ms a Professional Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Sparks, NV
  • NPI 1457473100
  NPD (past)

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1497106199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 GREEN VISTA DR STE 104",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894318515",
            "telephone_number": "775-674-1444",
            "fax_number": "775-674-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 GREEN VISTA DR STE 104",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894318515",
            "telephone_number": "775-674-1444",
            "fax_number": "775-674-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNG",
        "first_name": "KATHARINA",
        "middle_name": "S",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019032168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKenna Frith
• Harry Calvin Fry, DDS
• Pamela C Frye, RN
• Full Circle Counseling, PLLC
• Colin M Fuller, M.D.
• Kenneth Fung, RPH
• James Scott Furrow
• Alexis Cherie Gabrielson, APRN
• Gad 3 LLC
• Briana Galati Trout, DMD

• Orthodontics and Dentofacial Orthopedics Dentistry in Sparks, NV
• Providers in Sparks, NV by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.