NPIMap

Organization Active NPI

KRM Dental L.L.C

  • Dentist
  • East Syracuse, NY
National Provider Identifier
1457628562
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11540 Issued in IN
Legal business name
KRM DENTAL L.L.C
Practice address
281 Sanders Creek Pkwy
East Syracuse, NY 13057-1307
Phone
(866) 273-8204
Fax
(866) 803-4943
NPI assigned
Nov 18, 2011
Last updated
Nov 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Authorized official

Name
Dr. Katie Rebecca McNutt, D.M.D
Title
Owner
Phone
(317) 547-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 11540 IN Primary

Addresses

Primary practice location

281 Sanders Creek Pkwy
East Syracuse, NY 13057-1307

Mailing address

9940 Pendleton Pike
Suite B
Indianapolis, IN 46236-2823
Phone (317) 541-1900

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321574400000",
    "number": "1457628562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9940 PENDLETON PIKE",
            "address_2": "SUITE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462362823",
            "telephone_number": "317-541-1900",
            "fax_number": "317-897-8345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 SANDERS CREEK PKWY",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130571307",
            "telephone_number": "866-273-8204",
            "fax_number": "866-803-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRM DENTAL L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-11-18",
        "status": "A",
        "authorized_official_last_name": "MCNUTT",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-547-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "11540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.