Active NPI
Katherine Jean Lane, D.M.D, M.S.D
- Pediatric Dentistry
- Salem, OR
National Provider Identifier
1942357686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- D8774
- Practice address
- 5135 Skyline Rd S
Salem, OR 97306-9427 - Phone
- (541) 880-2090
- Fax
- (541) 880-2092
- NPI assigned
- Jan 4, 2007
- 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 | D8774 | OR | |
| Pediatric Dentistry | 1223P0221X | D8774 | OR | Primary |
Addresses
Primary practice location
5135 Skyline Rd S
Salem, OR 97306-9427
Mailing address
5111 Zosel Ave S
Salem, OR 97306-2103
Phone (503) 866-0920
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D8774 | Other | OR | OREGON DENTIST LICENSE |
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 |
|---|---|---|---|
| D8774 | OR | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403740800000",
"number": "1942357686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5111 ZOSEL AVE S",
"city": "SALEM",
"state": "OR",
"postal_code": "973062103",
"telephone_number": "503-866-0920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5135 SKYLINE RD S",
"city": "SALEM",
"state": "OR",
"postal_code": "973069427",
"telephone_number": "541-880-2090",
"fax_number": "541-880-2092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "KATHERINE",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "D.M.D, M.S.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2014-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D8774",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OR",
"license": "D8774",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON DENTIST LICENSE",
"identifier": "D8774",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.