1063639110 NPI number — ROBERT O KRON D.M.D.

Table of content: ROBERT O KRON D.M.D. (NPI 1063639110)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063639110 NPI number — ROBERT O KRON D.M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRON
Provider First Name:
ROBERT
Provider Middle Name:
O
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1063639110
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3535 W 12TH ST
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
GREELEY
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80634-2557
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-351-6095
Provider Business Mailing Address Fax Number:
970-351-0155

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3535 W 12TH ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
GREELEY
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80634-2557
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-351-6095
Provider Business Practice Location Address Fax Number:
970-351-0155
Provider Enumeration Date:
04/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  HD100893 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 02008936 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100893 . This is a "DENTAL" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 985184 . This is a "DENTAL" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 84465 . This is a "DENTAL" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com