Individual provider Active NPI

Donna G. Kraklow, D.D.S.

  • General Practice Dentistry
  • Waukesha, WI
National Provider Identifier
1174786545
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4732015 Issued in WI
Practice address
1507 E Sunset Dr
Suite 110
Waukesha, WI 53189-8203
Phone
(262) 547-4433
Fax
(262) 547-2977
NPI assigned
Jul 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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 4732015 WI Primary

Addresses

Primary practice location

1507 E Sunset Dr
Suite 110
Waukesha, WI 53189-8203

Mailing address

1507 E Sunset Dr
Suite 110
Waukesha, WI 53189-8203
Phone (262) 547-4433

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
4732015WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Donna G. Kraklow D.D.S. General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1174786545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 E SUNSET DR",
            "address_2": "SUITE 110",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531898203",
            "telephone_number": "262-547-4433",
            "fax_number": "262-547-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 E SUNSET DR",
            "address_2": "SUITE 110",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531898203",
            "telephone_number": "262-547-4433",
            "fax_number": "262-547-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAKLOW",
        "first_name": "DONNA",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4732015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; 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.