Jolene Alicia Krol, DMD

Individual provider Active NPI General Practice Dentistry · Lenox, MA

NPI 1134324155 · NPPES record last updated Dec 7, 2021

Key facts

NPI
1134324155
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
21839 (MA)
Practice address
55 Pittsfield Rd Ste 4C
Lenox, MA 01240-2185
Phone
(413) 298-3717
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150713000385 MA Order and Referring Only - Dentist
Practitioner - Dentist
0446562904

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
21839MAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 21839 MA Yes

Addresses

Primary practice location

55 Pittsfield Rd Ste 4C
Lenox, MA 01240-2185

Mailing address

55 Pittsfield Rd Ste 4C
Lenox, MA 01240-2185
Phone (413) 298-3717

Other practice location 1

20 Lewis Ave
Great Barrington, MA 01230-1827
Phone (413) 528-0181

Other providers in Lenox, MA

All providers in Lenox, MA · General Practice Dentistry in Massachusetts

Sources for this page

Verify at the official NPI Registry.