Kathryn Coury Connor, DDS
Individual provider Active NPI General Practice Dentistry · Wales, WI
NPI 1760610992 · NPPES record last updated Jan 15, 2018
Key facts
- NPI
- 1760610992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 6798 (WI)
- Practice address
- 300 E Summit Ave Ste C
Wales, WI 53183-9664 - Phone
- (262) 201-4718
- NPI assigned
- Jun 25, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151221000915 | WI | Order and Referring Only - Dentist |
1355642117 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6028 | LA | MD | Professional Counselor |
| 6798 | WI | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6028 | LA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 6798 | WI | Yes |
Addresses
Primary practice location
300 E Summit Ave Ste C
Wales, WI 53183-9664
Mailing address
300 E Summit Ave Ste C
Wales, WI 53183-9664
Phone (262) 201-4718
Other names
- Dr. Kathryn Janine Coury
Other providers in Wales, WI
- Timothy Dale Baron
- Carl D Below
- Sara Blando
- Natalie Bledstein
- Christopher Cole
- Margaret Davies
- Lauren Dolenshek
- Alissa Effland
- Sarah L Elliot
- Dawn Engelhardt
All providers in Wales, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.