Provider Demographics
NPI:1124452644
Name:KATIE STEELE DDS PLLC, STEELE PEDIATRIC DENTISTRY
Entity type:Organization
Organization Name:KATIE STEELE DDS PLLC, STEELE PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-580-8811
Mailing Address - Street 1:204 KRUGER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5165
Mailing Address - Country:US
Mailing Address - Phone:614-580-8811
Mailing Address - Fax:
Practice Address - Street 1:204 KRUGER ST STE 1
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-5165
Practice Address - Country:US
Practice Address - Phone:614-580-8811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV40431223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV4043OtherSTATE LICENSE
WV1952512063OtherNPI INDIVIDUAL