Active NPI
Mitchell W Kramer, D.D.S.
- Pediatric Dentistry
- Sartell, MN
National Provider Identifier
1912254160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- D13341
- Practice address
- 140 Twin Rivers CT
Sartell, MN 56377-2015 - Phone
- (320) 257-3380
- Fax
- (320) 257-3381
- NPI assigned
- Aug 7, 2012
- Last updated
- Apr 11, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | 7009 | NE | |
| Pediatric Dentistry | 1223P0221X | D13341 | MN | Primary |
Addresses
Primary practice location
140 Twin Rivers CT
Sartell, MN 56377-2015
Mailing address
140 Twin Rivers CT
Sartell, MN 56377-2015
Phone (320) 257-3380
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
| License | State | Type | Specialty |
|---|---|---|---|
| D13341 | MN | MD | Pediatric Dentist |
| 7009 | NE | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dentistry for Children, P.a. | Pediatric Dentistry | Past | Accepting new patients |
| Twin Anesthesia LLC | Single Specialty | Past | Accepting new patients |
Interoperability endpoints
- mkramer190040@direct.centracare.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatric Dentistry
- Sartell, MN
- NPI 1215299508
-
- Certified Registered Nurse Anesthetist
- Blaine, MN
- NPI 1558184739
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523404800000",
"number": "1912254160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 TWIN RIVERS CT",
"city": "SARTELL",
"state": "MN",
"postal_code": "563772015",
"telephone_number": "320-257-3380",
"fax_number": "320-257-3381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 TWIN RIVERS CT",
"city": "SARTELL",
"state": "MN",
"postal_code": "563772015",
"telephone_number": "320-257-3380",
"fax_number": "320-257-3381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRAMER",
"first_name": "MITCHELL",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-07",
"last_updated": "2018-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NE",
"license": "7009",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "MN",
"license": "D13341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sartell, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.