Provider Demographics
NPI:1518650308
Name:KRUM, SYDNEY LEEANN (DMD)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:LEEANN
Last Name:KRUM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16000 PROSPERITY DR STE 400
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-4322
Mailing Address - Country:US
Mailing Address - Phone:317-770-1050
Mailing Address - Fax:
Practice Address - Street 1:16000 PROSPERITY DR STE 400
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-4322
Practice Address - Country:US
Practice Address - Phone:317-770-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12014081A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice