Individual provider Active NPI

Michael Alan Krumnauer, DDS

  • General Practice Dentistry
  • Centerville, OH
National Provider Identifier
1659420958
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30018980 Issued in OH
Practice address
44 South Main Street
Centerville, OH 45458
Phone
(937) 433-7166
Fax
(937) 433-5669
NPI assigned
Jan 9, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 30018980 OH Primary

Addresses

Primary practice location

44 South Main Street
Centerville, OH 45458

Mailing address

44 South Main Street
Centerville, OH 45458
Phone (937) 433-7166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150530000185 OH Order and Referring Only - DentistPractitioner - Dentist 4587985700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30018980OHMDGeneral Practice Dentistry

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659420958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 SOUTH MAIN STREET",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "45458",
            "telephone_number": "937-433-7166",
            "fax_number": "937-433-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 SOUTH MAIN STREET",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "45458",
            "telephone_number": "937-433-7166",
            "fax_number": "937-433-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUMNAUER",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30018980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

Verify at the official NPI Registry.