Edward Krukowski

Primary specialty

DentistTaxonomy code 122300000X

License

DN11476 Issued in FL

Practice address

9801 Collins Ave
Suitec-102
Bal Harbour, FL 33154-1815

Phone

(305) 866-6662

Fax

(305) 866-6662

NPI assigned

May 9, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in FL

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

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.

• Edward a. Krukowski, DMD, PA

  • Dental Clinic/Center
  • Bal Harbour, FL
  • NPI 1942692223
  Authorized official Same address or phone

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275747305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 COLLINS AVE",
            "address_2": "SUITEC-102",
            "city": "BAL HARBOUR",
            "state": "FL",
            "postal_code": "331541815",
            "telephone_number": "305-866-6662",
            "fax_number": "305-866-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 COLLINS AVE",
            "address_2": "SUITEC-102",
            "city": "BAL HARBOUR",
            "state": "FL",
            "postal_code": "331541815",
            "telephone_number": "305-866-6662",
            "fax_number": "305-866-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUKOWSKI",
        "first_name": "EDWARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN11476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Bal Harbour, FL
• Providers in Bal Harbour, FL by specialty
• Dentist in Florida

• 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.
• 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.