Individual provider Active NPI

Katherine Sue Kula, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Indianapolis, IN
National Provider Identifier
1669505418
Registry record updated Jul 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
12011088A Issued in IN
Practice address
1121 W. Michigan Street
DS 307B
Indianapolis, IN 46202-5186
Phone
(317) 278-3632
Fax
(317) 274-2603
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 015966 MO
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 12011088A IN Primary

Addresses

Primary practice location

1121 W. Michigan Street
DS 307B
Indianapolis, IN 46202-5186

Mailing address

1121 W. Michigan Street
DS 307B
Indianapolis, IN 46202-5186
Phone (317) 278-3632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011088AINMDOrthodontics and Dentofacial Orthopedic Dentist
015966MOMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278720000000",
    "number": "1669505418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 W. MICHIGAN STREET",
            "address_2": "DS 307B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025186",
            "telephone_number": "317-278-3632",
            "fax_number": "317-274-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W. MICHIGAN STREET",
            "address_2": "DS 307B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025186",
            "telephone_number": "317-278-3632",
            "fax_number": "317-274-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULA",
        "first_name": "KATHERINE",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2010-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "015966",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "12011088A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2010; 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.