DR. KATHERINE MARY SMITH D.D.S.
NPI 1275889230
Dentist - Periodontics in St Louis Park, MN
About Dr. Katherine Mary Smith D.d.s. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KATHERINE MARY SMITH D.D.S. (NPI 1275889230) is an individual periodontics provider in St Louis Park, Minnesota, licensed in Minnesota (13599) and active in the NPI registry since July 2012. She has opted out of Medicare through September 20, 2026 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. Katherine Mary Smith D.d.s. 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 September 20, 2016 through September 20, 2026.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55426 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Katherine Smith's NPI number?
The NPI number for Katherine Smith is 1275889230. It was assigned to this individual provider in the NPPES registry on July 27, 2012. The provider is also known as Dr. Katherine Mary Motz D.D.S..
Where is Katherine Smith located?
Katherine Smith practices at 3555 Louisiana Ave S, St Louis Park, MN 55426. The listed phone number is (952) 935-9009.
What is Katherine Smith's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.
Is Katherine Smith enrolled in Medicare?
No. Katherine Smith has opted out of Medicare through September 20, 2026. 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.
When was this NPI record last updated?
The NPPES record for Katherine Smith was last updated on December 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.
# Dr. Katherine Mary Smith, D.D.S. · NPI 1275889230
Periodontics provider in St Louis Park, Minnesota. Individual provider, active in the CMS NPPES registry since July 27, 2012.
## Identity
- **NPI:** 1275889230 (Entity type: Individual)
- **Enumerated:** July 27, 2012
- **Primary specialty:** Dentist - Periodontics · taxonomy 1223P0300X
- **State license:** 13599 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 3555 LOUISIANA AVE S, St Louis Park, MN 55426-4121
- **Phone:** (952) 935-9009
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through September 20, 2026); services are provided under private contract
## Record status
- **NPPES last updated:** December 18, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1275889230) · Data from the CMS NPPES public registry.