Active NPI
John Keith Kreider, DMD
- General Practice Dentistry
- Fort Hood, TX
National Provider Identifier
1659712354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D-4502
- Practice address
- US Army Dental Activity
4431 68TH Street
Fort Hood, TX 76544 - Phone
- (254) 287-2705
- NPI assigned
- Jul 10, 2013
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D-4502 | ID | Primary |
Addresses
Primary practice location
US Army Dental Activity
4431 68TH Street
Fort Hood, TX 76544
Mailing address
US Army Dental Activity
36000 Darnall Loop Suite 1051
Fort Hood, TX 76544
Phone (254) 287-2705
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 |
|---|---|---|---|
| D-4502 | ID | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680566400000",
"number": "1659712354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "US ARMY DENTAL ACTIVITY",
"address_2": "36000 DARNALL LOOP SUITE 1051",
"city": "FORT HOOD",
"state": "TX",
"postal_code": "76544",
"telephone_number": "254-287-2705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "US ARMY DENTAL ACTIVITY",
"address_2": "4431 68TH STREET",
"city": "FORT HOOD",
"state": "TX",
"postal_code": "76544",
"telephone_number": "254-287-2705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KREIDER",
"first_name": "JOHN",
"middle_name": "KEITH",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-10",
"last_updated": "2023-04-04",
"certification_date": "2023-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D-4502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Hood, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.