Individual provider Active NPI

Elizabeth P Kravig, DDS

  • Dentist
  • Union Grove, WI
National Provider Identifier
1063668945
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6301 Issued in WI
Practice address
951 Main St
Suite 100
Union Grove, WI 53182-1343
Phone
(262) 878-2422
NPI assigned
Aug 12, 2008
Last updated
Aug 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6301 WI Primary

Addresses

Primary practice location

951 Main St
Suite 100
Union Grove, WI 53182-1343

Mailing address

951 Main St
Suite 100
Union Grove, WI 53182-1343
Phone (262) 878-2422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20160405001757 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0648577734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1063668945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 MAIN ST",
            "address_2": "SUITE 100",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821343",
            "telephone_number": "262-878-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 MAIN ST",
            "address_2": "SUITE 100",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821343",
            "telephone_number": "262-878-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAVIG",
        "first_name": "ELIZABETH",
        "middle_name": "P",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union Grove, WI

Sources for this page

Verify at the official NPI Registry.