Individual provider Active NPI

Karla Marie Kreger, DDS

  • General Practice Dentistry
  • Renton, WA
National Provider Identifier
1619081791
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6422 Issued in WA
Practice address
601 S Carr Rd Ste 340
Renton, WA 98055-5840
Phone
(425) 277-0204
Fax
(425) 204-1340
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6422 WA Primary

Addresses

Primary practice location

601 S Carr Rd Ste 340
Renton, WA 98055-5840

Mailing address

601 S Carr Rd Ste 340
Renton, WA 98055-5840
Phone (425) 277-0204

Other identifiers 2

IdentifierTypeStateIssuer
601-334-094-000OtherWAUBI
5009253OtherWAWDS #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150828001969 WA Order and Referring Only - DentistPractitioner - Dentist 9830405356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6422WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619081791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S CARR RD STE 340",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555840",
            "telephone_number": "425-277-0204",
            "fax_number": "425-204-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S CARR RD STE 340",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555840",
            "telephone_number": "425-277-0204",
            "fax_number": "425-204-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREGER",
        "first_name": "KARLA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBI",
            "identifier": "601-334-094-000",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WDS #",
            "identifier": "5009253",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.