Krista Lynn Wortman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901017295 Issued in MI

Practice address

8136 21 Mile Rd
Shelby TWP., MI 48317

Phone

(586) 726-0606

Fax

(586) 726-1523

NPI assigned

Oct 3, 2006

Sex

Female

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 MI

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

Practice roles

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.

• Summit Family Dental, P.L.L.C.

  • General Practice Dentistry
  • Shelby TWP., MI
  • NPI 1356435705
  NPD (past) Authorized official
• Summit Sleep Center, PLLC

  • General Practice Dentistry
  • Shelby Township, MI
  • NPI 1982488151
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093800633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8136 21 MILE RD",
            "city": "SHELBY TWP.",
            "state": "MI",
            "postal_code": "48317",
            "telephone_number": "586-726-0606",
            "fax_number": "586-726-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8136 21 MILE RD",
            "city": "SHELBY TWP.",
            "state": "MI",
            "postal_code": "48317",
            "telephone_number": "586-726-0606",
            "fax_number": "586-726-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTMAN",
        "first_name": "KRISTA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Wieckowski
• Jaimee Wilhelmsen, M.ED., BCBA, LBA
• John Patrick Willoughby, M.D.
• Megan Wilson, OTR/L
• Kristina Maria Wixon, D.O.
• Mark Charles Wortman, D.D.S.
• Daniel Wright, DPT
• Anna Wrobel, COTAL
• Lisa Yaxley
• Murray L Yoffee, DDS

• General Practice Dentistry in Shelby TWP., MI
• Providers in Shelby TWP., MI by specialty
• General Practice Dentistry in Michigan

• 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.

Verify at the official NPI Registry.