Active NPI
Paul H Krebsbach, DDS PHD
- Prosthodontics
- Ann Arbor, MI
National Provider Identifier
1891819934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 2901017077
- Practice address
- 1011 N University Ave
Ann Arbor, MI 48109-1078 - Phone
- (734) 763-5280
- Fax
- (734) 763-3453
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901017077 | MI | |
| Prosthodontics | 1223P0700X | 2901017077 | MI | Primary |
Addresses
Primary practice location
1011 N University Ave
Ann Arbor, MI 48109-1078
Mailing address
1011 N University Ave
Ann Arbor, MI 48109-1078
Phone (734) 763-5280
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 195816287 | Other | MI | BCBS OF MI MED SURGICAL |
| 4125504 | Medicaid | MI | |
| D170770 | Other | MI | BCBS OF MI DENTAL |
| 4125522 | Medicaid | MI |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901017077 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213660800000",
"number": "1891819934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 N UNIVERSITY AVE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481091078",
"telephone_number": "734-763-5280",
"fax_number": "734-763-3453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 N UNIVERSITY AVE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481091078",
"telephone_number": "734-763-5280",
"fax_number": "734-763-3453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KREBSBACH",
"first_name": "PAUL",
"middle_name": "H",
"credential": "DDS PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2008-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901017077",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MI",
"license": "2901017077",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MI MED SURGICAL",
"identifier": "195816287",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4125504",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MI DENTAL",
"identifier": "D170770",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4125522",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.