Richard Lynn Krantz, DDS
Individual provider Active NPI Dentist · Floyds Knobs, IN
NPI 1811978786 · NPPES record last updated Jan 18, 2008
Key facts
- NPI
- 1811978786
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 12008957B (IN)
- Practice address
- 4309 Country View Drive
Floyds Knobs, IN 47119 - Phone
- (812) 923-6581
- Fax
- (812) 923-6581
- NPI assigned
- Nov 8, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160126000802 | IN | Order and Referring Only - Dentist |
1052614047 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12008957B | IN | MD | Dentist |
| 3767 | KY | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3767 | KY | |
| Dentist | 122300000X | 12008957B | IN | Yes |
Addresses
Primary practice location
4309 Country View Drive
Floyds Knobs, IN 47119
Mailing address
2086 Old Hwy 135
Corydon, IN 47112
Phone (812) 734-1388
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60037678 | Medicaid | KY |
Other providers in Floyds Knobs, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.