1205997053 NPI number — DRS KRISHINGNER ROOT AND ASSOC PLLC

Table of content: (NPI 1205997053)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205997053 NPI number — DRS KRISHINGNER ROOT AND ASSOC PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS KRISHINGNER ROOT AND ASSOC PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MASSEY KRISHINGNER AND ROOT DDS
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205997053
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/13/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
123 EAST MAIN ST SUITE 300
Provider Second Line Business Mailing Address:
DRS KRISHINGNER ROOT AND ASSOC PLLC
Provider Business Mailing Address City Name:
BREVARD
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28712
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-884-3421
Provider Business Mailing Address Fax Number:
828-884-6336

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
123 EAST MAIN ST SUITE 300
Provider Second Line Business Practice Location Address:
DRS KRISHINGNER ROOT AND ASSOC PLLC
Provider Business Practice Location Address City Name:
BREVARD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-884-3421
Provider Business Practice Location Address Fax Number:
828-884-6336
Provider Enumeration Date:
12/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
OWEN
Authorized Official First Name:
AMBER
Authorized Official Middle Name:
N
Authorized Official Title or Position:
BILLING SPECIALIST
Authorized Official Telephone Number:
828-884-2801

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  6355 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 017V0 . This is a "BLUECROSSBLUESHEILD GROUP" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1205997053 . This is a "ORGANIZATIONAL NPI" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1134215957 . This is a "JOHN A KRISHINGNER NPI" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1295837482 . This is a "MILTON V MASSEY NPI" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8995066 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1639100209 . This is a "JEFFREY T ROOT NPI" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 5900566 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5900290 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8995505 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1366557134 . This is a "DAVID S KRISHINGNER NPI" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 5905642 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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