Krieg Phillip Pursifull – General Practice Dentistry

Key facts

NPI: 1871652610
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 04923 (VA)
Practice address: 132 N Locust St
Floyd, VA 24091-2103
Phone: (540) 745-4902
NPI assigned: Dec 7, 2006
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

French Family Dentistry,PLLC General Practice Dentistry · Floyd, VA · NPI 1952609489

NPD (past) GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
04923	VA	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
French Family Dentistry,PLLC	General Practice	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	04923	VA	Yes

Addresses

Primary practice location

132 N Locust St
Floyd, VA 24091-2103

Mailing address

132 N Locust St
Floyd, VA 24091-2103
Phone (540) 745-4902

Other identifiers

Identifier	Type	State	Issuer
065975	Other	VA	ANTHEM
7811517	Medicaid	VA

Other providers in Floyd, VA

All providers in Floyd, VA · General Practice Dentistry in Virginia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.