Elizabeth J Crocker, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

13434 Issued in MA

Practice address

103 Lake Shore Dr
Brewster, MA 02631-2429

Phone

(617) 571-1697

NPI assigned

Oct 1, 2012

Sex

Female

Sole proprietor

No

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

• Polished,LLC

  • Dental Hygienist
  • Brewster, MA
  • NPI 1104139708
  NPD (past)
• Vallyn,Inc

  • Public Health Dentistry
  • Brewster, MA
  • NPI 1093093007
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 1, 2012.

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1013268002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 LAKE SHORE DR",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026312429",
            "telephone_number": "617-571-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 LAKE SHORE DR",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026312429",
            "telephone_number": "617-571-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MA",
            "license": "13434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Patricia Condon, MA, LMHC
• Jill A Congdon, RDH
• Susan Karen Connolly, LICSW
• Lynn M Couto, RDH
• Erin Coutts, MSOT, OTR/L
• Roberta Cullen
• Julie Ruppert Cusack, M.A.
• Mahwish Rizvi Dar, CMHC
• Jack Darbyshire, ED.D.
• Margaret Davis, MS,RD,LDN,FADA,CDE

• All providers in Brewster, MA
• Dental Hygienist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.