Healthcare Provider Details

I. General information

NPI: 1952512063
Provider Name (Legal Business Name): KATHERINE JOAN STEELE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHERINE JOAN WELSH DDS

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 KRUGER STREET, SUITE 1
WHEELING WV
26003
US

IV. Provider business mailing address

204 KRUGER STREET, SUITE #1
WHEELING WV
26003
US

V. Phone/Fax

Practice location:
  • Phone: 304-243-5437
  • Fax: 304-243-5438
Mailing address:
  • Phone: 304-243-5437
  • Fax: 304-243-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number30.022392
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30-022392
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number4043
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: