Mary Krajicek

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

63547 Issued in CA

Practice address

1565 Hollenbeck Ave Ste 116
Sunnyvale, CA 94087-4300

Phone

(408) 736-6856

Fax

(408) 736-8606

NPI assigned

Aug 5, 2014

Last updated

Aug 5, 2014By the provider in NPPES

Sex

Female

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 MN

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Black Bear Dental PLLC

  dba Parkcenter Smiles

  • Dentist
  • Boise, ID
  • NPI 1710719216
  NPD Authorized official
• GCG Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Sunnyvale, CA
  • NPI 1821312547
  NPD (past)

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1265841183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 HOLLENBECK AVE STE 116",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940874300",
            "telephone_number": "408-736-6856",
            "fax_number": "408-736-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 HOLLENBECK AVE STE 116",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940874300",
            "telephone_number": "408-736-6856",
            "fax_number": "408-736-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAJICEK",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaileen Korte
• Lalitha N Kothuri, D.D.S.
• Bond Kou, PHARMD
• Kristina Kouris
• Eva Aleksandra Kowalewicz, PHD
• Alexandra Ludovina Krass
• Susan Lynn Krikorian, RN
• Sahana Harkere Krishnamurthy, MSPT
• Jeanette M Krogstad, PT
• Kathleen Marie Kronenwetter, MA CCC SLP

• General Practice Dentistry in Sunnyvale, CA
• Providers in Sunnyvale, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; 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.