Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jalissa Joy Kruckman, DDS

Individual provider General Practice Dentistry · NPI 1114238821

Jalissa Joy Kruckman, DDS is a General Practice Dentistry in Waconia, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2010
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

576 Cherry Dr
Waconia, MN 55387
Phone: (952) 679-4461
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence D12793 (MN)

Record details

NPI number1114238821
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorYes
NPI enumeratedJune 28, 2010
Last updated in NPPESJuly 16, 2018
Mailing address576 Cherry Dr, Waconia, MN 55387-4578

Other providers in Waconia