Individual provider Active NPI

Jeffrey C. Krahling, DDS

  • General Practice Dentistry
  • Meriden, CT
National Provider Identifier
1508061797
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
010395 Issued in CT
Practice address
12 Curtis St
Suite 14
Meriden, CT 06450-5900
Phone
(203) 238-1288
Fax
(203) 237-0696
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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 010395 CT Primary

Addresses

Primary practice location

12 Curtis St
Suite 14
Meriden, CT 06450-5900

Mailing address

666 W Baltimore St
Dentistry
Baltimore, MD 21201-1510
Phone (410) 706-3964

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
010395CTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1508061797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 W BALTIMORE ST",
            "address_2": "DENTISTRY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011510",
            "telephone_number": "410-706-3964",
            "fax_number": "410-706-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 CURTIS ST",
            "address_2": "SUITE 14",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064505900",
            "telephone_number": "203-238-1288",
            "fax_number": "203-237-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAHLING",
        "first_name": "JEFFREY",
        "middle_name": "C.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.