Individual provider Active NPI

Katerine Salgado Salgado, DMD

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1871222331
Registry record updated Jul 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN26896 Issued in FL
Practice address
9776 San Jose Blvd Ste 1
Jacksonville, FL 32257-5464
Phone
(904) 475-2177
NPI assigned
Jun 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN26896 FL Primary

Addresses

Primary practice location

9776 San Jose Blvd Ste 1
Jacksonville, FL 32257-5464

Mailing address

3386 Chrysler Dr
Jacksonville, FL 32257-5466
Phone (602) 783-0242

Other practice location 1

2804 Saint Johns Bluff Rd S
Jacksonville, FL 32246-3776
Phone (904) 493-1005

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

LicenseStateTypeSpecialty
DN26896FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jacksonville Florida North, PLLC PastSince Jan 12, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721520000000",
    "number": "1871222331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3386 CHRYSLER DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322575466",
            "telephone_number": "602-783-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9776 SAN JOSE BLVD STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322575464",
            "telephone_number": "904-475-2177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2804 Saint Johns Bluff Rd S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322463776",
            "country_code": "US",
            "telephone_number": "904-493-1005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALGADO SALGADO",
        "first_name": "KATERINE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2024-07-21",
        "certification_date": "2024-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2024; 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.