Lance William Kruse, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

840 Green Bay Rd
Winnetka, IL 60093-1864

Phone

(847) 446-3820

Fax

(847) 446-3707

NPI assigned

May 11, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205041431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 OLD WILLOW RD",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600932912",
            "telephone_number": "847-441-5233",
            "fax_number": "847-446-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 GREEN BAY RD",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600931864",
            "telephone_number": "847-446-3820",
            "fax_number": "847-446-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "LANCE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Eve S Kielson, MA LMFT LCPC
• Nelson Kim, PT, DPT
• Yoon Tae Kim, M.D.
• Katelyn G Kluckman, MS, CF-SLP
• Melissa Koehler
• Edy Kupietzky, MSW, PHD, MPH
• Thanh Thien Ha Lan, M.D.
• Susan S. Langan
• Margaret Buckner Lawson, D.P.M.
• Leah Wolff Pscychotherapy Inc

• General Practice Dentistry in Winnetka, IL
• Providers in Winnetka, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.