Robert Scott Krueger, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19A14900 Issued in IL

Practice address

636 Church St
Suite 309
Evanston, IL 60201-4508

Phone

(847) 328-1180

Fax

(847) 328-1189

NPI assigned

May 22, 2007

Sex

Male

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 IL

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.

• Town Centre Dental Group, LTD.

  • General Practice Dentistry
  • Evanston, IL
  • NPI 1154530459
  NPD (past) Authorized official

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154530590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST",
            "address_2": "SUITE 309",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014508",
            "telephone_number": "847-328-1180",
            "fax_number": "847-328-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST",
            "address_2": "SUITE 309",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014508",
            "telephone_number": "847-328-1180",
            "fax_number": "847-328-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19A14900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dolores Krebs, RDN
• Dean Kristl, M.D.
• Samantha Kroot
• Shannon K Kropp, MD
• Cassandra Therese Kruchten, MSW, LSW, LCSW
• Ktsmiles, Inc
• Jessica Kubacki
• Vandana Susmi Kulkarni, M.D.
• Eashan Kumar
• Himanshu Kumar

• General Practice Dentistry in Evanston, IL
• Providers in Evanston, 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 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.