Individual provider Active NPI

Holly Ann Krystek, DDS

  • General Practice Dentistry
  • Muscatine, IA
National Provider Identifier
1154484954
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7859 Issued in IA
Practice address
2920 Cedar St
Muscatine, IA 52761
Phone
(563) 263-9082
Fax
(563) 263-7984
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7859 IA Primary

Addresses

Primary practice location

2920 Cedar St
Muscatine, IA 52761

Mailing address

2920 Cedar St
Muscatine, IA 52761-2206
Phone (563) 263-9082

Other identifiers 1

IdentifierTypeStateIssuer
1180828MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7859IAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154484954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 CEDAR ST",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527612206",
            "telephone_number": "563-263-9082",
            "fax_number": "563-263-7984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 CEDAR ST",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "52761",
            "telephone_number": "563-263-9082",
            "fax_number": "563-263-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRYSTEK",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1180828",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muscatine, IA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.