Individual provider Active NPI

Kristin L Kratzer, DMD

  • General Practice Dentistry
  • Fountain Hill, PA
National Provider Identifier
1386873115
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS038511 Issued in PA
Practice address
1424 Broadway
Fountain Hill, PA 18015-4025
Phone
(610) 867-4461
Fax
(610) 867-9354
NPI assigned
Jul 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6094 OK
General Practice Dentistry 1223G0001X DS038511 PA Primary

Addresses

Primary practice location

1424 Broadway
Fountain Hill, PA 18015-4025

Mailing address

1424 Broadway
Fountain Hill, PA 18015-4025
Phone (610) 867-4461

Other names 1

  • Kristin L Kratzer Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS038511PAMDGeneral Practice Dentistry
6094OKMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1386873115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 BROADWAY",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180154025",
            "telephone_number": "610-867-4461",
            "fax_number": "610-867-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 BROADWAY",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180154025",
            "telephone_number": "610-867-4461",
            "fax_number": "610-867-9354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRATZER",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6094",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS038511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "KRATZER",
            "middle_name": "L",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fountain Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.