Active NPI
Michele Katherine Ah, D.D.S.
- Periodontics
- South Boston, VA
National Provider Identifier
1891871182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 0401007879
- Practice address
- 420 Hamilton Blvd
South Boston, VA 24592-5200 - Phone
- (434) 575-8488
- Fax
- (434) 575-0086
- NPI assigned
- Oct 28, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 0401007879 | VA | Primary |
Addresses
Primary practice location
420 Hamilton Blvd
South Boston, VA 24592-5200
Mailing address
420 Hamilton Blvd
South Boston, VA 24592-5200
Phone (434) 575-8488
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 |
|---|---|---|---|
| 0401007879 | VA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891871182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 HAMILTON BLVD",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245925200",
"telephone_number": "434-575-8488",
"fax_number": "434-575-0086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 HAMILTON BLVD",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245925200",
"telephone_number": "434-575-8488",
"fax_number": "434-575-0086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AH",
"first_name": "MICHELE",
"middle_name": "KATHERINE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "VA",
"license": "0401007879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Boston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.