Crosstown Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS025189L Issued in PA

Legal business name

CROSSTOWN DENTAL GROUP

Practice address

1230 E Main St
Palmyra, PA 17078-9505

Phone

(717) 838-5425

NPI assigned

Jun 15, 2017

Last updated

Jun 15, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Howard Kiessling, DMD

Title

Member

Phone

(717) 648-8695

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497484800000",
    "number": "1073043758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7230 REDTOP RD",
            "city": "HUMMELSTOWN",
            "state": "PA",
            "postal_code": "170369556",
            "telephone_number": "717-648-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 E MAIN ST",
            "city": "PALMYRA",
            "state": "PA",
            "postal_code": "170789505",
            "telephone_number": "717-838-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSTOWN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-15",
        "last_updated": "2017-06-15",
        "status": "A",
        "authorized_official_last_name": "KIESSLING",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "717-648-8695",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS025189L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; 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.