Kraig D. Osborne, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19020797 Issued in IL

Practice address

2501 W Iles Ave
Suite B
Springfield, IL 62704-4263

Phone

(217) 546-0351

Fax

(217) 546-0352

NPI assigned

Jan 12, 2007

Sex

Male

Sole proprietor

Yes

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 IL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Illinois Dental Sleep Center

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1760211494
  NPD Authorized official

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1073663738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 W ILES AVE",
            "address_2": "SUITE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044263",
            "telephone_number": "217-546-0351",
            "fax_number": "217-546-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W ILES AVE",
            "address_2": "SUITE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044263",
            "telephone_number": "217-546-0351",
            "fax_number": "217-546-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "KRAIG",
        "middle_name": "D.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19020797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orthopaedic Center of Illinois
• Orthopaedic Center of Illinois
• Orthopaedic Surgery Center of Illinois, LLC
• Miguel Angel Ortiz Rivera, MD
• Melinda Osborn, LCPC
• Stephanie A Osborne, CRNA
• Melissa M. Osowski, FNP-BC
• Mary Lynn Ossowski, LCSW
• Kendra Lynn Ostermeier, LPC
• Lindsey Ostermeier, FNP

• General Practice Dentistry in Springfield, IL
• Providers in Springfield, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.