Individual provider Active NPI

Erich Frederick Kronenwett, D.M.D.

  • General Practice Dentistry
  • Acton, MA
National Provider Identifier
1992893499
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1880820 Issued in MA
Practice address
179 Great Rd
Suite 204
Acton, MA 01720-5777
Phone
(978) 263-3526
Fax
(978) 263-5888
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1880820 MA Primary

Addresses

Primary practice location

179 Great Rd
Suite 204
Acton, MA 01720-5777

Mailing address

179 Great Rd
Suite 204
Acton, MA 01720-5777
Phone (978) 263-3526

Other identifiers 2

IdentifierTypeStateIssuer
1452868OtherPAUNITED CONCORDIA
X07362OtherMABC/BS OF MA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20150807013627 MA Order and Referring Only - DentistPractitioner - Dentist 5799099594

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1880820MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Acton Dental Associates, P.C. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992893499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 GREAT RD",
            "address_2": "SUITE 204",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017205777",
            "telephone_number": "978-263-3526",
            "fax_number": "978-263-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 GREAT RD",
            "address_2": "SUITE 204",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017205777",
            "telephone_number": "978-263-3526",
            "fax_number": "978-263-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRONENWETT",
        "first_name": "ERICH",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "1880820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1452868",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MA",
            "identifier": "X07362",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Acton, MA

Sources for this page

Verify at the official NPI Registry.