Kristin Elizabeth Kaiser, DDS
Individual provider Active NPI Dentist · Pemberville, OH
NPI 1154543049 · NPPES record last updated Sep 12, 2013
Key facts
- NPI
- 1154543049
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 21852 (OH)
- Practice address
- 401 W College Ave
Pemberville, OH 43450-9495 - Phone
- (419) 287-3205
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150626000262 | OH | Order and Referring Only - Oral Surgery |
5890006274 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21852 | OH | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shawn Lee Thompson DDS Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 21852 | OH | Yes |
Addresses
Primary practice location
401 W College Ave
Pemberville, OH 43450-9495
Mailing address
63 Linden LN
Perrysburg, OH 43551-2141
Phone (419) 350-6768
Other providers in Pemberville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.