Nathan Phillip Krueger, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

1001603 Issued in WI

Practice address

4660 W College Ave
Appleton, WI 54913-8507

Phone

(920) 730-0345

NPI assigned

Jun 23, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dental Associates LTD of Wisconsin

  • Endodontics
  • Wauwatosa, WI
  • NPI 1518266998
  NPD (past)

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1912427642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14233 W VIA MANANA",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853752238",
            "telephone_number": "928-503-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 W COLLEGE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138507",
            "telephone_number": "920-730-0345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "NATHAN",
        "middle_name": "PHILLIP",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-23",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kailee Kruck
• April Marie Krueger, OTR MS
• Douglas Alan Krueger, D.D.SS.
• Mary Krueger
• Michael A Krueger, MD
• Joseph John Krupka, O.D.
• Anna Corrine Krupp
• Catherine Kay Kruschel, APNP
• Jenifer Krzanowski, CCC-SLP
• Stephanie Nicole Ksionda, OTR/L

• Dentist in Appleton, WI
• Providers in Appleton, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.