Mary Kaitlin Cardullo, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D11547 Issued in OR

Practice address

8568 SW Apple Way
Portland, OR 97225-1772

Phone

(503) 292-6773

NPI assigned

Dec 31, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kate Cardullo Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1640908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640908800000",
    "number": "1619638764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142642",
            "telephone_number": "304-651-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8568 SW APPLE WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251772",
            "telephone_number": "503-292-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDULLO",
        "first_name": "MARY",
        "middle_name": "KAITLIN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-31",
        "last_updated": "2021-12-31",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "CARDULLO",
            "credential": "DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lorelynn Mirage Cardo, PHD
• Gina Teresa Cardona, CNM
• Jessica Cardone
• Casey Naimat Cardoso, EP-C, EIM, LMT
• Gianna Carducci
• David Cardus
• Beth Alison Cardwell, MD
• Danielle Teresa Cardwell
• Lori Cardwell, MD
• Silas Cardwell III, MD

• Dentist in Portland, OR
• Providers in Portland, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2021; 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.