John Max Crestetto, DDS,MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6759 Issued in NC

Practice address

901 N Winstead Ave
Suite 130
Rocky Mount, NC 27804-8467

Phone

(252) 443-7331

Fax

(252) 937-2381

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 1, 2017 through Mar 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• DRS. Barringer & Crestetto,P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Rocky Mount, NC
  • NPI 1770625121
  NPD (past)
• K. Kevin Neshat, DDS, MD, PA

  dba Nu-Image Surgical Center

  • Oral and Maxillofacial Surgery Clinic/Center
  • Raleigh, NC
  • NPI 1770637779
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1063597375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N WINSTEAD AVE",
            "address_2": "SUITE 130",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048467",
            "telephone_number": "252-443-7331",
            "fax_number": "252-937-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N WINSTEAD AVE",
            "address_2": "SUITE 130",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048467",
            "telephone_number": "252-443-7331",
            "fax_number": "252-937-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESTETTO",
        "first_name": "JOHN",
        "middle_name": "MAX",
        "name_prefix": "Dr.",
        "credential": "DDS,MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "6759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102X",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990023",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Cox, MSCCC-SLP
• David Watkins Craig, PHARMD
• Randy Gordon Crawford, RPH
• Jeskell Creecy
• Michael Crenshaw Sr., CHAPLAIN
• Anna Marie Crist, NP
• Daniel Lind Crocker, M.D.
• Crossroads Family Pharmacy Inc
• Crossworks Inc
• Frank Thomas Curlings Jr., QPBSED

• Oral and Maxillofacial Surgery (Dentist) in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.