Active NPI
Crystal Jane Rosenbrook, RDH
- Dental Hygienist
- Woodbury, MN
National Provider Identifier
1568793768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 10573-016
- Practice address
- 3194 Leyland TRL
Woodbury, MN 55125-3558 - Phone
- (715) 559-6638
- NPI assigned
- Jan 27, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 10573-016 | WI | Primary |
Addresses
Primary practice location
3194 Leyland TRL
Woodbury, MN 55125-3558
Mailing address
3194 Leyland TRL
Woodbury, MN 55125-3558
Phone (715) 559-6638
Other names 1
- Ms. Crystal Jane Baures
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10573-016 | WI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512259200000",
"number": "1568793768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3194 LEYLAND TRL",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551253558",
"telephone_number": "715-559-6638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3194 LEYLAND TRL",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551253558",
"telephone_number": "715-559-6638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBROOK",
"first_name": "CRYSTAL",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-27",
"last_updated": "2017-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "10573-016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CRYSTAL",
"last_name": "BAURES",
"middle_name": "JANE",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.