Active NPI
Kathleen McMannes, LDH
- Dental Hygienist
- Gary, IN
National Provider Identifier
1730670639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 13007475A
- Practice address
- 4629 Melton Rd
Gary, IN 46403-2866 - Phone
- (219) 938-2637
- NPI assigned
- May 25, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 13007475A | IN | Primary |
Addresses
Primary practice location
4629 Melton Rd
Gary, IN 46403-2866
Mailing address
1267 W 95TH PL
Crown Point, IN 46307-2276
Phone (219) 628-5295
Other practice location 1
3229 Broadway
Gary, IN 46409-1036
Phone (219) 806-3000 ext. 34
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13007475A | IN | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527206400000",
"number": "1730670639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1267 W 95TH PL",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463072276",
"telephone_number": "219-628-5295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4629 MELTON RD",
"city": "GARY",
"state": "IN",
"postal_code": "464032866",
"telephone_number": "219-938-2637"
}
],
"practiceLocations": [
{
"address_1": "3229 Broadway",
"address_purpose": "LOCATION",
"city": "Gary",
"state": "IN",
"postal_code": "464091036",
"country_code": "US",
"telephone_number": "219-806-3000 x34",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCMANNES",
"first_name": "KATHLEEN",
"credential": "LDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-25",
"last_updated": "2018-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "IN",
"license": "13007475A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gary, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.