=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134073653
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DUBOIS ORAL SURGERY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/23/2026
-----------------------------------------------------
Last Update Date | 02/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 90 BEAVER DR STE 209D
-----------------------------------------------------
City | DU BOIS
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15801-2449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-299-5151
-----------------------------------------------------
Fax | 814-299-5156
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 90 BEAVER DR STE 209D
-----------------------------------------------------
City | DU BOIS
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15801-2449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-299-5151
-----------------------------------------------------
Fax | 814-299-5156
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ORAL SURGEON
-----------------------------------------------------
Name | DR. KATHERINE N RICHARDSON
-----------------------------------------------------
Credential | MS, DDS
-----------------------------------------------------
Telephone | 814-299-5151
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 204E00000X
-----------------------------------------------------
Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------