Individual provider Active NPI

Chad Edward Kriskovich, DDS

  • Dentist
  • Billings, MT
National Provider Identifier
1669489530
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2129 Issued in MT
Practice address
2700 Grand Avenue
Suite D
Billings, MT 59102
Phone
(406) 259-5700
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2129 MT Primary

Addresses

Primary practice location

2700 Grand Avenue
Suite D
Billings, MT 59102

Mailing address

2700 Grand Avenue
Suite D
Billings, MT 59102
Phone (406) 259-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20160603001191 MT Order and Referring Only - DentistPractitioner - Dentist 6507156536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2129MTMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1669489530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 GRAND AVENUE",
            "address_2": "SUITE D",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "59102",
            "telephone_number": "406-259-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 GRAND AVENUE",
            "address_2": "SUITE D",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "59102",
            "telephone_number": "406-259-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISKOVICH",
        "first_name": "CHAD",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MT",
            "license": "2129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.