Kathryn Elizabeth Ritchie, DDS

Key facts

NPI: 1821436619
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 12011993A (IN)
Practice address: 3099 Central Ave
Lake Station, IN 46405-2207
Phone: (219) 763-8112
Fax: (219) 764-3251
NPI assigned: Jun 13, 2013
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Enrolled in IN
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
I20160215002159	IN	Order and Referring Only - Oral Surgery Practitioner - Oral Surgery	0749584597

National Provider Directory

Medicare enrollment (NPD): Yes

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	12011993A	IN	Yes

Addresses

Primary practice location

3099 Central Ave
Lake Station, IN 46405-2207

Mailing address

PO Box 1430
Portage, IN 46368-9230
Phone (219) 763-8112

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 7, 2015.

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1821436619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463689230",
            "telephone_number": "219-763-8112",
            "fax_number": "219-764-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3099 CENTRAL AVE",
            "city": "LAKE STATION",
            "state": "IN",
            "postal_code": "464052207",
            "telephone_number": "219-763-8112",
            "fax_number": "219-764-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RITCHIE",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-13",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011993A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Station, IN

All providers in Lake Station, IN · General Practice Dentistry in Indiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2015. 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.

Verify at the official NPI Registry.