Krystal Clear Hearing Center PLLC
Organization Active NPI Audiologist · Dickinson, ND
NPI 1326779604 · NPPES record last updated Jun 18, 2022
Key facts
- NPI
- 1326779604
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Audiologist 231H00000X
- Legal business name
- KRYSTAL CLEAR HEARING CENTER PLLC
- Practice address
- 1674 15TH St W Ste a
Dickinson, ND 58601-2810 - Phone
- (701) 483-6500
- NPI assigned
- Jun 18, 2022
- Organization subpart
- No
Authorized official
- Name
- Krystal Mann, AUD
- Title
- Owner
- Phone
- (701) 483-6500
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220829003244 | ND | Part B Supplier - Clinic/Group Practice | 1052795713 |
Receives reassigned benefits from 1 practitioner Practice locations: Dickinson, ND |
National Provider Directory
Locations
1674 15th St W
Ste Awes
Dickinson, ND 58601
1674 15th St W
Ste A
Dickinson, ND 58601
Phone (701) 483-6500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist |
231H00000X | Yes |
Addresses
Primary practice location
1674 15TH St W Ste a
Dickinson, ND 58601-2810
Mailing address
1674 15TH St W Ste a
Dickinson, ND 58601-2810
Phone (701) 483-6500
Other providers in Dickinson, ND
- Timothy Kreidt
- Krieg Family Dental
- Bethanie Krieg
- Kelli Nicole Krieg
- Dacotah Krushevsky
- Laynee R Kudrna
- Tyson Kudrna
- Amanda Kuhn
- Jan Schulte Kuhn
- Miranda Kuhn
All providers in Dickinson, ND · Audiologist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.