Nelson Charles Krum Jr., DDS

Key facts

NPI

1316948136

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

License

121 (MP)

Practice address

Wakins BLDG. 125 Middle Rd. Gualo Rai
Saipan, MP 96950

Phone

(670) 234-4040

Fax

(670) 488-1044

NPI assigned

Aug 2, 2005

Sex

Male

Sole proprietor

No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Paradise Dental Services, Inc. Dental Clinic/Center · Saipan, MP · NPI 1265056881
  NPD Authorized official
• Perfect Teeth - Union & Academy P.C. General Practice Dentistry · Colorado Springs, CO · NPI 1528189925
  NPD (past) GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 28, 2020.

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1316948136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80918",
            "telephone_number": "719-260-6093",
            "fax_number": "719-260-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WAKINS BLDG. 125 MIDDLE RD. GUALO RAI",
            "city": "SAIPAN",
            "state": "MP",
            "postal_code": "96950",
            "telephone_number": "670-234-4040",
            "fax_number": "670-488-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUM",
        "first_name": "NELSON",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "4499",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MP",
            "license": "121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dohyun Kim, PA-C
• Jihyun Kim
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• Jiayi Kong, MD
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• Laura Kyonka
• Susan Mae Laidlaw, MD
• LCS-Cnmi, Inc.
• Nicole Leblanc, PT

All providers in Saipan, MP · General Practice Dentistry in Northern Mariana Islands