SHANNON MARIE KRUCKEBERG RDH NPI 1003002882

Dental Hygienist in Claremont, MN

Individual Female Dental Hygienist

About SHANNON KRUCKEBERG

Shannon Kruckeberg is a provider established in Claremont, Minnesota and her medical specialization is dental hygienist. The NPI number of Shannon Kruckeberg is 1003002882 and was assigned on September 2007. The practitioner's primary taxonomy code is 124Q00000X with license number H6343 (MN). The provider is registered as an individual and her NPI record was last updated 11 years ago.

Shannon Kruckeberg is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

NPI

1003002882

Provider Name SHANNON MARIE KRUCKEBERG RDH
Provider Location Address63407 130TH AVE CLAREMONT, MN 55924
Provider Mailing Address63407 130TH AVE CLAREMONT, MN 55924
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date09-14-2007
Last Update Date11-16-2009

Primary Taxonomy

Taxonomy Code124Q00000X
ClassificationDental Hygienist
TypeDental Providers
License No.H6343
License StateMN
Taxonomy DescriptionAn individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary.

Business Address

SHANNON MARIE KRUCKEBERG RDH
63407 130TH AVE
CLAREMONT, MN
ZIP 55924
Phone: (507) 319-6845

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Mailing Address

SHANNON MARIE KRUCKEBERG RDH
63407 130TH AVE
CLAREMONT, MN
ZIP 55924
Phone: (507) 319-6845

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1861720245HEALTHY SMILES, INC.
Organization
Voluntary or Charitable63407 130TH AVE
CLAREMONT, MN 55924
(507) 319-6845

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.