Gary D. Krueger, DDS, Apc

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

42347 Issued in NY

Legal business name

GARY D. KRUEGER, DDS, APC

Practice address

320 Santa Fe Dr
Suite 201
Encinitas, CA 92024-5138

Phone

(760) 479-0961

Fax

(760) 479-0963

NPI assigned

Apr 16, 2014

Organization subpart

No

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

Authorized official

Name

Gary Douglas Krueger, D.D.S.

Title

Maxillofacial Prosthodontist

Phone

(760) 479-0961

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397606400000",
    "number": "1225457328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 SANTA FE DRIVE",
            "address_2": "SUITE 201",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245140",
            "telephone_number": "760-479-0961",
            "fax_number": "760-479-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SANTA FE DR",
            "address_2": "SUITE 201",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245138",
            "telephone_number": "760-479-0961",
            "fax_number": "760-479-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY D. KRUEGER, DDS, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-16",
        "last_updated": "2014-04-16",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "MAXILLOFACIAL PROSTHODONTIST",
        "authorized_official_telephone_number": "760-479-0961",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "42347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthodontics in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Prosthodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.