OrganizationActive
Kruckman Family Dentistry
NPI 1457134785 · Dental Clinic/Center · Waconia, MN
Kruckman Family Dentistry is a Dental Clinic/Center organization in Waconia, MN (NPI 1457134785).
Provider details
- NPI number
- 1457134785
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jalissa Kruckman, Owner(952) 679-4461
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
141 Depot Dr
Waconia, MN 55387-1874
Phone: (952) 679-4461
Street-level locationGet directions
Mailing address
141 Depot Dr
Waconia, MN 55387-1874
Other names (DBA / former)
- Other name
- Kruckman Family Dentistry
Registry dates
- Enumerated
- 2023-08-18
- Last updated
- 2023-08-18
- Certified
- 2023-08-18
Frequently asked questions
- What is Kruckman Family Dentistry's NPI number?
- Kruckman Family Dentistry's National Provider Identifier (NPI) is 1457134785, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kruckman Family Dentistry?
- Kruckman Family Dentistry is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Kruckman Family Dentistry located?
- Kruckman Family Dentistry's practice location on file with NPPES is 141 Depot Dr, Waconia, MN 55387-1874.
- What is Kruckman Family Dentistry's phone number?
- The practice phone number listed in the NPPES registry for Kruckman Family Dentistry is (952) 679-4461.
- Who is the authorized official for Kruckman Family Dentistry?
- The authorized official listed on Kruckman Family Dentistry's NPPES record is Jalissa Kruckman, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kruckman Family Dentistry's NPI active?
- Yes — Kruckman Family Dentistry's NPI (1457134785) is active in the NPPES registry as of the last update on 2023-08-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.