Individual provider Active NPI

Johan Jacob Kritzinger, DDS

  • General Practice Dentistry
  • Victorville, CA
National Provider Identifier
1750893145
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS102106 Issued in CA
Practice address
13792 Bear Valley Rd # 1
Victorville, CA 92392-8713
Phone
(760) 245-2010
NPI assigned
Oct 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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 DDS102106 CA Primary

Addresses

Primary practice location

13792 Bear Valley Rd # 1
Victorville, CA 92392-8713

Mailing address

25959 Campo CV
Loma Linda, CA 92354-6531
Phone (909) 343-3446

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

LicenseStateTypeSpecialty
DDS102106CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1750893145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25959 CAMPO CV",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923546531",
            "telephone_number": "909-343-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13792 BEAR VALLEY RD # 1",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923928713",
            "telephone_number": "760-245-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRITZINGER",
        "first_name": "JOHAN",
        "middle_name": "JACOB",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-25",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS102106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.