Active NPI
Tristram Coffin Kruger, D.D.S., M.S.
- Dentist
- Potomac, MD
National Provider Identifier
1588988166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6536
- Practice address
- 9641 Accord Dr.
Potomac, MD 20854-4305 - Phone
- (301) 983-2290
- Fax
- (301) 983-2290
- NPI assigned
- Mar 25, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6536 | MD | Primary |
Addresses
Primary practice location
9641 Accord Dr.
Potomac, MD 20854-4305
Mailing address
9641 Accord Dr.
Potomac, MD 20854-4305
Phone (301) 983-2290
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6536 | MD | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269475200000",
"number": "1588988166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9641 ACCORD DR.",
"city": "POTOMAC",
"state": "MD",
"postal_code": "208544305",
"telephone_number": "301-983-2290",
"fax_number": "301-983-2290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9641 ACCORD DR.",
"city": "POTOMAC",
"state": "MD",
"postal_code": "208544305",
"telephone_number": "301-983-2290",
"fax_number": "301-983-2290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUGER",
"first_name": "TRISTRAM",
"middle_name": "COFFIN",
"name_prefix": "Dr.",
"credential": "D.D.S., M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-25",
"last_updated": "2010-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "6536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Potomac, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.