Provider Demographics
NPI:1073687836
Name:KRAGER, KAREN M (DDS)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:M
Last Name:KRAGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:M
Other - Last Name:KRAGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2410 SOUTH 73RD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124
Mailing Address - Country:US
Mailing Address - Phone:402-397-3394
Mailing Address - Fax:402-393-8593
Practice Address - Street 1:2410 SOUTH 73RD ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124
Practice Address - Country:US
Practice Address - Phone:402-397-3394
Practice Address - Fax:402-393-8593
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5716122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE03904OtherBCBS NE
NE520308OtherUNITED CONCORDIA
NE47081928200Medicaid