Active NPI
Jared T Krieger, DMD
- Periodontics
- Altamonte Springs, FL
National Provider Identifier
1003961871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN12734
- Practice address
- 707 Pennsylvania Ave
Suite 1200
Altamonte Springs, FL 32701-6471 - Phone
- (407) 478-5002
- NPI assigned
- Jan 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN12734 | FL | Primary |
Addresses
Primary practice location
707 Pennsylvania Ave
Suite 1200
Altamonte Springs, FL 32701-6471
Mailing address
1307 Tadsworth Ter
Heathrow, FL 32746-5333
Phone (407) 333-4644
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190204001947 | FL | Order and Referring Only - Dentist | 9335486018 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN12734 | FL | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003961871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1307 TADSWORTH TER",
"city": "HEATHROW",
"state": "FL",
"postal_code": "327465333",
"telephone_number": "407-333-4644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 PENNSYLVANIA AVE",
"address_2": "SUITE 1200",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327016471",
"telephone_number": "407-478-5002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRIEGER",
"first_name": "JARED",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "DN12734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altamonte Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.