SHANNON MARIE KRUCKEBERG (NPI# 1003002882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003002882 |
| Entity Type | Individual |
| Full Name | SHANNON MARIE KRUCKEBERG |
| Credential | RDH |
| Practice Address |
63407 130th Ave Claremont MN 55924-4656 |
| Practice Telephone | 5073196845 |
| Mailing Telephone | 5073196845 |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2009-11-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | H6343 | MN | Dental Providers |
| Street Address |
63407 130TH AVE |
| City | CLAREMONT |
| State | MN |
| Zip Code | 55924-4656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861720245 | Healthy Smiles, Inc. | Voluntary or Charitable | 63407 130th Ave, Claremont, MN 55924-4656 | 2009-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760782494 | Dawn Michelle Nuss | Counselor | 13788 630th St, Claremont, MN 55924-4614 | 2010-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433432 | Jessica E Macleod | Psychologist | 165 Broad St # 65, Claremont, NH 03743-3611 | 2020-09-30 |
| 1891301214 | Sharon Samantha Stannislaus | Student in an Organized Health Care Education/Training Program | 604 Richbrook Dr, Claremont, CA 91711-3646 | 2020-09-21 |
| 1013523786 | Lauryn Berretta | Student in an Organized Health Care Education/Training Program | 114 Windsor Rd, Claremont, NH 03743-4117 | 2020-09-18 |
| 1093321036 | Jennifer Maynard | Speech-Language Pathologist | 160 Hanover St, Claremont, NH 03743 | 2020-09-16 |
| 1699380816 | Goldsmith Psychology, Inc | Counselor | 101 N Indian Hill Blvd Ste C2-202, Claremont, CA 91711-4670 | 2020-09-14 |
| 1073127197 | Michelle Leah Ginsberg | Dentist | 4517 Liveoak Dr, Claremont, CA 91711-2104 | 2020-09-04 |
| 1184237372 | Nicollette Sokoeun Buth | Nurse Practitioner | 1426 Fergus Fls, Claremont, CA 91711-8316 | 2020-08-26 |
| 1518575265 | Gaston Family Health Services, Inc. | Clinic/Center | 4675 Oxford School Rd, Claremont, NC 28610-9468 | 2020-07-20 |
| 1285251520 | Stephanie Minami | Dietitian, Registered | 532 Chouinard Cir, Claremont, CA 91711-2232 | 2020-07-02 |
| 1841812336 | Giana, LLC | Assisted Living Facility | 4263 La Junta Dr, Claremont, CA 91711-2351 | 2020-05-07 |
| Find all providers in CLAREMONT | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| 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. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306238118 | Kyle W Messier | Dental Hygienist | 1 Tremont St., Claremont, NH 03743 | 2015-03-03 |
| 1841534377 | Irma Jo Bejarano | Dental Hygienist | 155 Kirkwood Ave, Claremont, CA 91711-5033 | 2012-11-21 |
| 1407190804 | Sabrina Santucho | Dental Hygienist | 155 Kirkwood Ave, Claremont, CA 91711-5033 | 2012-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104440825 | Sara Marie Anderson | Dental Hygienist | 6213 Saint Croix Trl N Apt 208, Oak Park Heights, MN 55082-6967 | 2020-05-29 |
| 1760027460 | Claire Roesler | Dental Hygienist | 903 Center St W # 103, Rochester, MN 55902-6278 | 2019-11-18 |
| 1225689060 | Kylie Anderson | Dental Hygienist | 903 Center St W Ste 130, Rochester, MN 55902-6278 | 2019-09-23 |
| 1770130387 | Sandra Kay Weitemier | Dental Hygienist | 25555 Gramford Ave, Wyoming, MN 55092-9356 | 2019-08-20 |
| 1912552803 | Gabrielle Anne Yoon | Dental Hygienist | 321 Labree Ave N, Thief River Falls, MN 56701-2019 | 2019-08-07 |
| 1841758851 | Susan Janine Ferrell | Dental Hygienist | East Side Dental, 895 East 7th Street, St Paul, MN 55106 | 2019-03-08 |
| 1619435682 | Maureen O'sullivan | Dental Hygienist | 385 S Owasso Blvd W, Roseville, MN 55113-2119 | 2019-03-07 |
| 1598237307 | Kelli Marie Fena | Dental Hygienist | 1613 Farm Rd S, Tower, MN 55790-5579 | 2018-12-19 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1053829721 | Rhonda Jean Schwalbe | Dental Hygienist | 727 4th St N, Virginia, MN 55792-2369 | 2018-01-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.