Kathryn Ashley Edgcomb, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

021002415 Issued in IL

Practice address

1376 Reid Farm Rd
Rockford, IL 61107-2679

Phone

(815) 494-8884

NPI assigned

Feb 25, 2011

Last updated

Aug 12, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1609173749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1376 REID FARM RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072679",
            "telephone_number": "815-494-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1376 REID FARM RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072679",
            "telephone_number": "815-494-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGCOMB",
        "first_name": "KATHRYN",
        "middle_name": "ASHLEY",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-25",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028542",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021002415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gareth A Eberle, MD
• Brenda Alis Echeverria, APRN
• Joseph J Eckburg, MD
• Courtney R Eckhoff, APRN
• Jithinraj Edakkanambeth Varayil, MD
• Leslie Paul Edgcomb, M.D.
• Edgebrook Dermatology P.C.
• Edgebrook Dermatology, PC.
• Edgebrook Physical Therapy, Inc. (CORA Physical Therapy - Edgebrook)
• Emma Edgell, PTA

• Orthodontics and Dentofacial Orthopedics Dentistry in Rockford, IL
• Providers in Rockford, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; 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.