Individual provider Active NPI

Katherine Elizabeth Vanderhorst, D.D.S.

  • General Practice Dentistry
  • Fairfield, OH
National Provider Identifier
1972749976
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30022907 Issued in OH
Practice address
1246 Nilles Rd Ste 3
Fairfield, OH 45014-2785
Phone
(513) 829-1117
Fax
(513) 829-2881
NPI assigned
Dec 21, 2008
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30022907 OH
General Practice Dentistry 1223G0001X 30022907 OH Primary

Addresses

Primary practice location

1246 Nilles Rd Ste 3
Fairfield, OH 45014-2785

Mailing address

1246 Nilles Rd Ste 3
Fairfield, OH 45014-2785
Phone (513) 829-1117

Other names 1

  • Dr. Katherine Elizabeth Miller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170509001190 OH Order and Referring Only - DentistPractitioner - Dentist 4284911876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30022907OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey L. Wilden D.D.S.,Inc. Dentist Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1229817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1972749976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1246 NILLES RD STE 3",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142785",
            "telephone_number": "513-829-1117",
            "fax_number": "513-829-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1246 NILLES RD STE 3",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142785",
            "telephone_number": "513-829-1117",
            "fax_number": "513-829-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERHORST",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-21",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30022907",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30022907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "MILLER",
            "middle_name": "ELIZABETH",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.