1437598661 NPI number — K-TOWN RIDERS

Table of content: DR. DAVID HARVEY KRINSKY D.M.D. (NPI 1962625715)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437598661 NPI number — K-TOWN RIDERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
K-TOWN RIDERS
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:
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:
1437598661
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4415 WHITTLE SPRINGS RD
Provider Second Line Business Mailing Address:
APT 30
Provider Business Mailing Address City Name:
KNOXVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37917-1544
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-208-2249
Provider Business Mailing Address Fax Number:
877-703-3065

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4415 WHITTLE SPRINGS RD
Provider Second Line Business Practice Location Address:
APT 30
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37917-1544
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-208-2249
Provider Business Practice Location Address Fax Number:
877-703-3065
Provider Enumeration Date:
06/20/2013

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
KEELIN
Authorized Official Middle Name:
JAFARI
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
865-208-2249

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: PENDING , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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