Nathanael Joseph Kreager, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D13221 Issued in MN

Practice address

1963 Robert St S # 100
West Saint Paul, MN 55118-3942

Phone

(651) 505-3242

NPI assigned

Jun 4, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1689012320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1963 ROBERT ST S # 100",
            "city": "WEST SAINT PAUL",
            "state": "MN",
            "postal_code": "551183942",
            "telephone_number": "651-505-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1963 ROBERT ST S # 100",
            "city": "WEST SAINT PAUL",
            "state": "MN",
            "postal_code": "551183942",
            "telephone_number": "651-505-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREAGER",
        "first_name": "NATHANAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-04",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13221",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "7154-15",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Sterling Johnston, DDS
• Julie Joloka
• Chris Keck-Cardona, M.D.
• Lauren Lee Ketchmark, PHARMD
• Patrick Q Knoedler, MD
• Peter Lee Ladd, D.C.
• Christina Marie Losasso, NP
• Lubomir Serafimov DDS , P.a.
• Kendall Wike Matthews, PA-C
• Menon Periodontics and Implants, LLC

• Dentist in West Saint Paul, MN
• Providers in West Saint Paul, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.