Organization Active NPI

Kreshtool & Kim Endodontics PA

  • Endodontics
  • Wilmington, DE
National Provider Identifier
1083717094
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
KRESHTOOL & KIM ENDODONTICS PA
Practice address
1815 W 13TH Street
Suite #7
Wilmington, DE 19806-4054
Phone
(302) 652-3556
Fax
(302) 654-8088
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Daniel R Kreshtool, DDSNPI 1487757464
Title
President
Phone
(302) 652-3556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

1815 W 13TH Street
Suite #7
Wilmington, DE 19806-4054

Mailing address

1815 W 13TH Street
Suite #7
Wilmington, DE 19806-4054
Phone (302) 652-3556

Other identifiers 2

IdentifierTypeStateIssuer
0001186931MedicaidDE
264118OtherUNITED CONCORDIA

National Provider Directory

National Provider Directory

Locations

1815 W 13th St
Ste 7
Wilmington, DE 19806
Phone (302) 652-3556

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083717094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 W 13TH STREET",
            "address_2": "SUITE #7",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198064054",
            "telephone_number": "302-652-3556",
            "fax_number": "302-654-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 W 13TH STREET",
            "address_2": "SUITE #7",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198064054",
            "telephone_number": "302-652-3556",
            "fax_number": "302-654-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRESHTOOL & KIM ENDODONTICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRESHTOOL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-652-3556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001186931",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "264118",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.