Doctor profile · Federal record
Dr. Jalissa Kruckman, DDS
General Practice Dentistry · Waconia, MN
- NPI 1114238821
- 16 yrs on file
- Female
- Solo practice
- No sanctions
Practice & contact
- Primary practice
-
576 Cherry Dr
Waconia, MN 55387
(952) 679-4461
Credentials & registration
- NPI registered
- June 2010 — 16 yrs on file
- Profile last updated
- July 16, 2018
- Specialty taxonomy
- 1223G0001X — NUCC code
- State license (1)
- Minnesota #D12793
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1114238821. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$44
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Solventum Corporation | 1 | $44.41 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
17
Patients
16
Total drug cost
$90
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Amoxicillin | Generic | 17 | 16 | $90 |
Frequently asked questions
What is Dr. Jalissa Kruckman's medical specialty?
Dr. Jalissa Kruckman practices General Practice Dentistry in Waconia, MN.
Where does Dr. Jalissa Kruckman practice?
Dr. Jalissa Kruckman practices at 576 Cherry Dr, Waconia, MN 55387. Office phone: 9526794461.
What is Dr. Jalissa Kruckman's NPI?
Dr. Jalissa Kruckman's National Provider Identifier (NPI) is 1114238821, issued by NPPES.