Spencer James Kruse, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12011139 Issued in IN

Practice address

6425 N Keystone Ave
Indianapolis, IN 46220-2158

Phone

(317) 255-2941

Fax

(317) 255-1656

NPI assigned

Aug 26, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1043467657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 N KEYSTONE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202158",
            "telephone_number": "317-255-2941",
            "fax_number": "317-255-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 N KEYSTONE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202158",
            "telephone_number": "317-255-2941",
            "fax_number": "317-255-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "SPENCER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-26",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher David Krumrei
• Nadia Lynn Krupp, M.D.
• Rachel Rene Krupp, PA-C
• Randall Wade Krupsaw, PH.D.
• Paul W Kruse, MD
• Cheryl Krushinski, DDS
• Madeline Blackwell Krusing, MD
• Bonnie Jean Kruszka, NP
• Nicolette Angela Kruzich, PA-C
• Kaytlyn L Kryshak, DC

• Dentist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.

Verify at the official NPI Registry.