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SHANNON MARIE KRUCKEBERG RDH NPI 1003002882


NPI Profile

NPI: 1003002882
Provider Name: SHANNON MARIE KRUCKEBERG, RDH
Classification:Dental Hygienist - 124Q00000X
Entity Type: Individual
Address:
63407 130TH AVE
CLAREMONT, MN
ZIP 55924
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Phone: (507) 319-6845

Shannon Marie Kruckeberg, RDH is a dental hygienist in Claremont, MN. The provider is an 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. Shannon Marie Kruckeberg, RDH NPI is 1003002882. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

63407 130TH AVE
CLAREMONT, MN
ZIP 55924-656
Phone: (507) 319-6845

The enumeration date for this NPI number is 9/14/2007 and was last updated on 11/16/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1124Q00000XDental HygienistH6343MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/7/2021

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