Madhuri Katta, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12402 Issued in NC

Practice address

3875 Conlon Way Ste a
Elizabeth City, NC 27909-9607

Phone

(252) 679-3143

NPI assigned

Jul 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1831762756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 RIVER COVE LN",
            "city": "HERTFORD",
            "state": "NC",
            "postal_code": "279449133",
            "telephone_number": "205-960-2458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3875 CONLON WAY STE A",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279099607",
            "telephone_number": "252-679-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATTA",
        "first_name": "MADHURI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaleb C Thompson, DMD, PA Iiii
• Kaleb C. Thompson, DMD, PA
• Joann Kaminski, LCAS
• Karen Monique Wuertz, DDS, PA
• Karl W Hubbard, MD Orthopedics & Sports Medicine
• Kristin Nickla Kaul, M.S., L.P.A., HSP-PA
• Jada Keebler, RBT
• Jennifer Newsham Keeler, MED, CCC-SLP
• Magdeline Barbara Keller Clemens, RPH
• Caitlyn Kelley

• General Practice Dentistry in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.