Individual provider Active NPI

Robert Thomas Kreutz, DDS

  • General Practice Dentistry
  • Jackson, NJ
National Provider Identifier
1306816830
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI01398400 Issued in NJ
Practice address
2046 W County Line Rd
Suite 1
Jackson, NJ 08527-2014
Phone
(732) 905-9932
Fax
(732) 905-7289
NPI assigned
Jan 26, 2006
Last updated
Sep 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 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 22DI01398400 NJ Primary

Addresses

Primary practice location

2046 W County Line Rd
Suite 1
Jackson, NJ 08527-2014

Mailing address

506 Hunters Rd
Brick, NJ 08724-4614
Phone (732) 892-9148

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI01398400NJMDGeneral Practice Dentistry

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

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221177600000",
    "number": "1306816830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 HUNTERS RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087244614",
            "telephone_number": "732-892-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 W COUNTY LINE RD",
            "address_2": "SUITE 1",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272014",
            "telephone_number": "732-905-9932",
            "fax_number": "732-905-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREUTZ",
        "first_name": "ROBERT",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2008-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01398400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.