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DR. KATHLEEN GOOD EDERLE DDS
NPI 1174875249
Dentist in Little Rock, AR

Active since October 12, 2012Opted out of Medicare · through Apr 14, 2027
413 N. UNIVERSITY AVE., LITTLE ROCK, AR 72205(501) 664-6040(501) 537-0479 Get Directions Write a Review

NPPES record last updated: October 12, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kathleen Good Ederle Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KATHLEEN GOOD EDERLE DDS (NPI 1174875249) is an individual dentist in Little Rock, Arkansas, licensed in Arkansas (2739) and active in the NPI registry since October 2012. She has opted out of Medicare through April 14, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1174875249
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. KATHLEEN GOOD EDERLECredential: DDS
Location Address413 N. UNIVERSITY AVE.Little Rock, AR 72205
Mailing Address413 N. University Ave.Little Rock, AR 72205 · (501) 664-6040 · Fax (501) 537-0479
Phone(501) 664-6040
Fax(501) 537-0479
Sole ProprietorYes
Enumeration DateOctober 12, 2012
✔ NPI 1174875249 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in AR · 2739
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
413 N. UNIVERSITY AVE., Little Rock, AR 72205
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Other Identifiers 1

Other1223G0001XAR · Bcbs Of Tn

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of Arkansas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Dr. Kathleen Good Ederle Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 14, 2015 through April 14, 2027.

Opt-Out Effective DateApril 14, 2015
Opt-Out In Effect ThroughApril 14, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72205 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$79.72 typical visit price
range $51.36 – $157.74
Typical copayment $19.93 (range $12.84 – $39.43)
Most-billed visit code 99203
Established Patient
$64.56 typical visit price
range $16.16 – $128.77
Typical copayment $16.14 (range $4.04 – $32.19)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kathleen Ederle's NPI number?

The NPI number for Kathleen Ederle is 1174875249. It was assigned to this individual provider in the NPPES registry on October 12, 2012.

Where is Kathleen Ederle located?

Kathleen Ederle practices at 413 N. University Ave., Little Rock, AR 72205. The listed phone number is (501) 664-6040.

What is Kathleen Ederle's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Kathleen Ederle enrolled in Medicare?

No. Kathleen Ederle has opted out of Medicare through April 14, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Kathleen Ederle accept?

Health plans from Delta Dental of Arkansas list Kathleen Ederle as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kathleen Ederle was last updated on October 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.