Active NPI
Katelyn Michelle Radner, DMD
- General Practice Dentistry
- Tampa, FL
National Provider Identifier
1811556509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN24201
- Practice address
- 3680 W Gandy Blvd
Tampa, FL 33611-2608 - Phone
- (813) 820-0063
- NPI assigned
- Jun 6, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN24201 | FL | |
| General Practice Dentistry | 1223G0001X | DN24201 | FL | Primary |
Addresses
Primary practice location
3680 W Gandy Blvd
Tampa, FL 33611-2608
Mailing address
4423 Connery CT
Palm Harbor, FL 34685-3137
Phone (727) 599-4841
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 |
|---|---|---|---|
| DN24201 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559779200000",
"number": "1811556509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4423 CONNERY CT",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346853137",
"telephone_number": "727-599-4841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3680 W GANDY BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336112608",
"telephone_number": "813-820-0063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADNER",
"first_name": "KATELYN",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-06",
"last_updated": "2019-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN24201",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN24201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.