Charles Joseph Krusa, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS2393 Issued in TN

Practice address

289 Highland SQ
Crossville, TN 38555-5105

Phone

(931) 484-3664

Fax

(931) 707-5640

NPI assigned

Oct 31, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr. Charles J. Krusa, D.D.S.

  • Dental Clinic/Center
  • Crossville, TN
  • NPI 1134312226
  NPD (past) Authorized official
• Zander Dentistry PLLC

  • Dental Clinic/Center
  • Crossville, TN
  • NPI 1285133553
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1497746440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 HIGHLAND SQ",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385555105",
            "telephone_number": "931-484-3664",
            "fax_number": "931-707-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 HIGHLAND SQ",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385555105",
            "telephone_number": "931-484-3664",
            "fax_number": "931-707-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSA",
        "first_name": "CHARLES",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS2393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammad Hassan Koucheki, M.D., P.C.
• Angela Dee Krech, RDH
• Erin Krismanits
• Kroger Limited Partnership I
• Kroger Limited Partnership I
• Chennakesava Reddy Kummathi, M.D
• Darwin Kurth
• Jana Brielle Lack, PA-C
• Callan Brooke Lamoreaux, H.I.S.
• Joshua Lampert, PTA

• General Practice Dentistry in Crossville, TN
• Providers in Crossville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.