Individual Healthcare Provider
Krista S Primley
Provider's NPPES record last updated: May 19, 2026
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1073013025
- Primary Specialty
- Dentist — Oral and Maxillofacial Surgery
- Practice Location
- Green Bay, Wisconsin
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 9:09 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Dentist
Oral and Maxillofacial Surgery
Dental Providers
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Taxonomy code 1223S0112X Student in an Organized Health Care Education/Training Program
Student, Health Care
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Taxonomy code 390200000X
Provider-Reported License Information
- Dentist (Wisconsin)
- 6001396
- Dentist (Minnesota)
- D14292
- Student in an Organized Health Care Education/Training Program (Iowa)
- RES-30533
Practice Locations
Practice Location
2581 Development Dr
Green Bay, Wisconsin 54311-4247
Phone: (920) 347-0400
Additional Practice Location
636 N 12th Ave
Sturgeon Bay, Wisconsin 54235-1249
Phone: (920) 743-2001
Fax: (920) 347-0868
Additional Practice Location
930 Maritime Dr
Manitowoc, Wisconsin 54220-2961
Phone: (920) 682-9121
Fax: (920) 347-0868
Additional Practice Location
200 Hawkins Dr
Iowa City, Iowa 52242-1009
Phone: (319) 356-7339
Additional Practice Location
515 Delaware St Se
Minneapolis, Minnesota 55455
Phone: (612) 624-8600
Additional Practice Location
8515 Eagle Point Blvd Ste 200
Lake Elmo, Minnesota 55042-8624
Phone: (651) 523-9950
Record Information
- Enumeration Date
- February 16, 2018
- Provider's NPPES Record Last Updated
- May 19, 2026
- Certification Date
- May 19, 2026
- NPISignal NPPES Dataset
- August 2026
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