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DR. KURT BRUKSCH D.D.S.
NPI 1154339448
Dentist - Oral and Maxillofacial Surgery in Crystal Lake, IL

Active since August 03, 2006Opted out of Medicare · through May 24, 2028
690 NORTH ROUTE #31, CRYSTAL LAKE, IL 60012(815) 459-5600(815) 459-5601 Get Directions Write a Review

NPPES record last updated: June 23, 2010. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Dr. Kurt Bruksch D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KURT BRUKSCH D.D.S. (NPI 1154339448) is an individual oral and maxillofacial surgery provider in Crystal Lake, Illinois, licensed in Wisconsin (3721) and active in the NPI registry since August 2006. He has opted out of Medicare through May 24, 2028.

NPPES Registry Identity

NPI1154339448
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. KURT BRUKSCHCredential: D.D.S.
Location Address690 NORTH ROUTE #31Crystal Lake, IL 60012
Mailing Address690 North Route #31Crystal Lake, IL 60012 · (815) 459-5600 · Fax (815) 459-5601
Phone(815) 459-5600
Fax(815) 459-5601
Sole ProprietorNo
Enumeration DateAugust 3, 2006
Last NPPES UpdateJune 23, 2010
✔ NPI 1154339448 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses✔ Licensed in WI · 3721✔ Licensed in IL · 019018137
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
690 NORTH ROUTE #31, Crystal Lake, IL 60012
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Other Identifiers 3

Medicare UPINT38692WI
Medicare ID-Type Unspecified76484WI
Medicare ID-Type Unspecified761910IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Kurt Bruksch D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 24, 2022 through May 24, 2028.

Opt-Out Effective DateMay 24, 2022
Opt-Out In Effect ThroughMay 24, 2028Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kurt Bruksch's NPI number?

The NPI number for Kurt Bruksch is 1154339448. It was assigned to this individual provider in the NPPES registry on August 3, 2006.

Where is Kurt Bruksch located?

Kurt Bruksch practices at 690 North Route #31, Crystal Lake, IL 60012. The listed phone number is (815) 459-5600.

What is Kurt Bruksch's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Kurt Bruksch enrolled in Medicare?

No. Kurt Bruksch has opted out of Medicare through May 24, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Kurt Bruksch was last updated on June 23, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.