DR. MARK DAVID KRULL (NPI# 1902397425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902397425 |
| Entity Type | Individual |
| Full Name | DR. MARK DAVID KRULL |
| Credential | DDS |
| Practice Address |
13300 S West Bay Shore Dr Ste 1 Traverse City MI 49684-5571 |
| Mailing Address |
8866 Manhattan N Traverse City MI 49685-5823 |
| Practice Telephone | 2319460207 |
| Mailing Telephone | 2312183944 |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2019-11-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2901022619 | MI | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1500 Caberfae Hwy, Manistee, MI 496609200 | 2317238272 |
| Street Address |
13300 S WEST BAY SHORE DR STE 1 |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-5571 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114563012 | Harborside Dental Pllc | Dentist | 13300 S West Bay Shore Dr Ste 1, Traverse City, MI 49684-5571 | 2019-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104355148 | Daniel Robert Fisher | Dentist | 10767 E Traverse Hwy Ste B, Traverse City, MI 49684-6219 | 2017-06-04 |
| 1619238987 | Matthew Jonathon Green | Dentist | 421 Second St, Traverse City, MI 49684-2004 | 2012-06-04 |
| 1881912491 | Grandview Dental Care Pllc | Dentist | 421 2nd St Ste 1, Traverse City, MI 49684-2004 | 2010-05-06 |
| 1891937470 | Timothy Donald Wentzloff | Dentist | 876 E Front St, Traverse City, MI 49686-2704 | 2009-03-30 |
| 1699930453 | Heather Anne Pfefferle | Dentist | 1429 Barlow St., Traverse City, MI 49686 | 2008-07-22 |
| 1497956643 | Ronald C. Chao | Dentist | 2815 Garfield Rd N, Traverse City, MI 49686-5005 | 2007-05-29 |
| 1902019623 | Grapevine Denture Service | Dentist | 865 Us Highway 31 S, Traverse City, MI 49684-8716 | 2007-05-08 |
| 1902925506 | Thomas C. Salon | Dentist | 1061 E Front St, Traverse City, MI 49686-2707 | 2007-03-28 |
| 1801925854 | Stanley M Smyka | Dentist | 1208 E 8th St, Traverse City, MI 49686-2939 | 2007-03-05 |
| 1144356692 | Fred Deckert Stoye Jr. | Dentist | 3258 Bowers Harbor Rd, Traverse City, MI 49686-9737 | 2007-02-26 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
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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.