Provider Demographics
NPI:1497196323
Name:SALMON, KATHERINE MARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:MARIE
Last Name:SALMON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:MARIE
Other - Last Name:HOLLENKAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:220 THOMAS MORE PKWY
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3424
Mailing Address - Country:US
Mailing Address - Phone:859-341-3012
Mailing Address - Fax:
Practice Address - Street 1:220 THOMAS MORE PKWY
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3424
Practice Address - Country:US
Practice Address - Phone:593-413-0128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-024013122300000X
KY93851223P0221X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100336020Medicaid