Individual provider Active NPI

Michael Thomas Kratz, DDS

  • General Practice Dentistry
  • Edina, MN
National Provider Identifier
1356457683
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D10956 Issued in MN
Practice address
3939 W 50TH St
#208
Edina, MN 55424
Phone
(952) 922-2214
Fax
(952) 922-3903
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 D10956 MN Primary

Addresses

Primary practice location

3939 W 50TH St
#208
Edina, MN 55424

Mailing address

3939 W 50TH St
#208
Edina, MN 55424
Phone (952) 922-2214

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220711000489 MN Practitioner - Dentist 0042435711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D10956MNMDGeneral 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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356457683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 W 50TH ST",
            "address_2": "#208",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55424",
            "telephone_number": "952-922-2214",
            "fax_number": "952-922-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 W 50TH ST",
            "address_2": "#208",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55424",
            "telephone_number": "952-922-2214",
            "fax_number": "952-922-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRATZ",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D10956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.