Crutchfield Pediatric Dental Group

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

58211 Issued in CA

Legal business name

CRUTCHFIELD PEDIATRIC DENTAL GROUP

Practice address

6560 Lonetree Blvd Ste 102
Rocklin, CA 95765-5891

Phone

(916) 773-5230

Fax

(916) 474-5249

NPI assigned

Jun 27, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Jude Crutchfield, DMDNPI 1184886657

Title

Owner

Phone

(916) 773-5230

Specialties & licenses 1

Addresses

Other names 1

• Roseville Kids Dentist Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jude Crutchfield, D.M.D

  • Pediatric Dentistry
  • Rocklin, CA
  • NPI 1184886657
  NPD Authorized official
• Cuauhtemoc Gonzalez, DDS

  • Pediatric Dentistry
  • Rocklin, CA
  • NPI 1366839193
  NPD (past)

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1033639463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 PARK DR",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957655562",
            "telephone_number": "916-435-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6560 LONETREE BLVD STE 102",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957655891",
            "telephone_number": "916-773-5230",
            "fax_number": "916-474-5249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRUTCHFIELD PEDIATRIC DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "CRUTCHFIELD",
        "authorized_official_first_name": "JUDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-773-5230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "58211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roseville Kids Dentist",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Roseville Kids Dentist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ileana Rose Craig
• Sage Craig
• Carissa Crail, RN, IBCLC
• Walter John Crawford, PT
• Amanda Crudo, RBT
• Jude Crutchfield, D.M.D
• Christopher Cruz
• Alicia Eve Cukjati, IBCLC
• Christina Cullison, M.A. CCC-SLP
• Samantha Culver

• Pediatric Dentistry in Rocklin, CA
• Providers in Rocklin, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.