Healthcare Provider Details

I. General information

NPI: 1184285033
Provider Name (Legal Business Name): KRICKET LYNN KOEHN D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2019
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

922 MARGARET ST
RHINELANDER WI
54501-3923
US

IV. Provider business mailing address

922 MARGARET ST
RHINELANDER WI
54501-3923
US

V. Phone/Fax

Practice location:
  • Phone: 715-365-6859
  • Fax: 715-362-7060
Mailing address:
  • Phone: 715-365-6859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number1002131-15
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1002131-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: