DR. SHANE GREGORY KROHNFELDT DDS NPI 1164937421

NPI Information

NPI: 1164937421
Provider Name: DR. SHANE GREGORY KROHNFELDT, DDS
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

PECOS Registration: Yes

Address:
6425 HOLLY AVE NE
ALBUQUERQUE, NM
ZIP 87113
Phone: (505) 828-2020
Get Directions

DR. Shane Gregory Krohnfeldt, DDS is a general practice dentist in Albuquerque, NM. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Shane Gregory Krohnfeldt, DDS NPI is 1164937421. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6425 HOLLY AVE NE
ALBUQUERQUE, NM
ZIP 87113-474
Phone: (505) 828-2020

The NPI 1164937421 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 12/8/2017 and was last updated on 11/2/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		DD4823	NEW MEXICO	No
2	1223G0001X	Dentist	General Practice	103623	CALIFORNIA	No
3	1223G0001X	Dentist	General Practice	DD4823	NEW MEXICO	Yes

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: 4/28/2024

NPI Synchronization or Removal

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