Individual provider Active NPI

Tom Kramkowski, DDS

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1366538266
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6196-015 Issued in WI
Practice address
3520 W Oklahoma Ave
Milwaukee, WI 53215-4175
Phone
(414) 645-0365
Fax
(414) 645-1052
NPI assigned
Oct 5, 2006
Last updated
Feb 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6196-015 WI Primary
General Practice Dentistry 1223G0001X 5647 AZ

Addresses

Primary practice location

3520 W Oklahoma Ave
Milwaukee, WI 53215-4175

Mailing address

8861 Ravenswood Cir
Wauwatosa, WI 53226-4670
Phone (520) 247-8530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150710002739 AZ Order and Referring Only - DentistPractitioner - Dentist 0749592285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6196-015WIMDDentist
5647AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul D Smith D.D.S., S.C. Dba Jackson Park Family Dental Dentist PastSince Oct 10, 2021 Accepting new patients

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1366538266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8861 RAVENSWOOD CIR",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264670",
            "telephone_number": "520-247-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154175",
            "telephone_number": "414-645-0365",
            "fax_number": "414-645-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAMKOWSKI",
        "first_name": "TOM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6196-015",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5647",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.