Benjamin Alan Crunk, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4004 Issued in AL

Practice address

980 Main St
Montevallo, AL 35115-3847

Phone

(205) 665-2031

Fax

(205) 665-5560

NPI assigned

Jul 26, 2006

Last updated

Jul 12, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Benjamin a. Crunk, DDS, LLC

  • General Practice Dentistry
  • Montevallo, AL
  • NPI 1083638746
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1003830134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 MAIN ST",
            "city": "MONTEVALLO",
            "state": "AL",
            "postal_code": "351153847",
            "telephone_number": "205-665-2031",
            "fax_number": "205-665-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 MAIN ST",
            "city": "MONTEVALLO",
            "state": "AL",
            "postal_code": "351153847",
            "telephone_number": "205-665-2031",
            "fax_number": "205-665-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUNK",
        "first_name": "BENJAMIN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF AL PROVIDER #",
            "identifier": "510-03995",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Montevallo, AL
• Providers in Montevallo, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.