Randall Scott Krebs, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D012199 Issued in AZ

Practice address

5855 W Utopia Rd
Glendale, AZ 85308-5251

Phone

(623) 537-6000

Fax

(623) 806-7689

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 23, 2024 through Jul 23, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rkrebs24969@direct.midwestern.edu

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.

• Midwestern University

  • Dental Clinic/Center
  • Glendale, AZ
  • NPI 1164744009
  NPD
• Midwestern University

  • Optometrist
  • Glendale, AZ
  • NPI 1891017745
  NPD (past)
• Aaron T. Gubler, DMD, LLC

  • Dental Clinic/Center
  • Antigo, WI
  • NPI 1467998294
  NPD (past)
• Complete Dental Center, S.C.

  • Dentist
  • Antigo, WI
  • NPI 1295819134
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1649354564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19389 N 59TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086500",
            "telephone_number": "623-537-6000",
            "fax_number": "623-806-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 W UTOPIA RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085251",
            "telephone_number": "623-537-6000",
            "fax_number": "623-806-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREBS",
        "first_name": "RANDALL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4672",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415484",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Kramer, D.O.
• April Krause, N.D.
• Michael L Kravetz, MD
• Mary Kay Krawczyk, LCSW
• Kreative Solutions LLC
• Morgan Kreifels, OTR/L
• Melissa Kreitner
• Rachel Kreul
• Allison Leigh Krisak
• Krishna Medical PLLC

• General Practice Dentistry in Glendale, AZ
• Providers in Glendale, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.