Roy Elton Crowder Jr., DDS

Individual provider Active NPI General Practice Dentistry · Ripley, TN

NPI 1083602197 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1083602197
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS004048 (TN)
Practice address
1800 Highway 51 S
Ripley, TN 38063-5598
Phone
(731) 635-5000
Fax
(731) 635-7540
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20161028001055 TN Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
3870871627

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DS004048TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Crowder Family Dental Care, PC Past Accepting new patients
Elite Dental Care Ripley Past
since Jul 31, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS004048 TN Yes

Addresses

Primary practice location

1800 Highway 51 S
Ripley, TN 38063-5598

Mailing address

1800 Highway 51 S
Ripley, TN 38063-5598
Phone (731) 635-5000

Other providers in Ripley, TN

All providers in Ripley, TN · General Practice Dentistry in Tennessee

Sources for this page

Verify at the official NPI Registry.