Active NPI
Jonathan S Krochmal, DDS
- Dentist
- Wayland, MA
National Provider Identifier
1649582479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN1855909
- Practice address
- 16 Lakeview Rd
Wayland, MA 01778-4214 - Phone
- (757) 636-0378
- NPI assigned
- Jul 9, 2010
- Sex
- Male
- Sole proprietor
- No
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 | DN1855909 | MA | Primary |
Addresses
Primary practice location
16 Lakeview Rd
Wayland, MA 01778-4214
Mailing address
16 Lakeview Rd
Wayland, MA 01778-4214
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 |
|---|---|---|---|
| DN1855909 | MA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Krochmal Dental Inc | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Roslindale, MA
- NPI 1194447789
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402272000000",
"number": "1649582479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 LAKEVIEW RD",
"city": "WAYLAND",
"state": "MA",
"postal_code": "017784214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 LAKEVIEW RD",
"city": "WAYLAND",
"state": "MA",
"postal_code": "017784214",
"telephone_number": "757-636-0378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KROCHMAL",
"first_name": "JONATHAN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-09",
"last_updated": "2014-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1855909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayland, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.