Individual provider Active NPI

Justin Thomas Cromwell, D.D.S.

  • Dentist
  • Marysville, OH
National Provider Identifier
1023208766
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.022556 Issued in OH
Practice address
450 Colemans Xing
Marysville, OH 43040-7129
Phone
(937) 738-7610
Fax
(937) 738-7614
NPI assigned
Jul 30, 2007
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.022556 OH Primary

Addresses

Primary practice location

450 Colemans Xing
Marysville, OH 43040-7129

Mailing address

450 Colemans Xing
Marysville, OH 43040-7129
Phone (937) 738-7610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30.022556OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1023208766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 COLEMANS XING",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430407129",
            "telephone_number": "937-738-7610",
            "fax_number": "937-738-7614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 COLEMANS XING",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430407129",
            "telephone_number": "937-738-7610",
            "fax_number": "937-738-7614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROMWELL",
        "first_name": "JUSTIN",
        "middle_name": "THOMAS",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.022556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.