Provider Demographics
NPI:1952512063
Name:STEELE, KATHERINE JOAN (DDS)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:JOAN
Last Name:STEELE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:JOAN
Other - Last Name:WELSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:204 KRUGER STREET, SUITE #1
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003
Mailing Address - Country:US
Mailing Address - Phone:304-243-5437
Mailing Address - Fax:304-243-5438
Practice Address - Street 1:204 KRUGER STREET, SUITE 1
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003
Practice Address - Country:US
Practice Address - Phone:304-243-5437
Practice Address - Fax:304-243-5438
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0223921223G0001X
OH30.022392122300000X
WV40431223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3910000733Medicaid