Benjamin a. Crunk, DDS, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4004 Issued in AL

Legal business name

BENJAMIN A. CRUNK, DDS, LLC

Practice address

980 Main St
Montevallo, AL 35115-3846

Phone

(205) 665-2031

Fax

(205) 665-5560

NPI assigned

Jul 26, 2006

Last updated

Jun 23, 2008By 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. Benjamin Alan Crunk, DDSNPI 1003830134

Title

Owner

Phone

(205) 665-2031

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin Alan Crunk, DDS

  • General Practice Dentistry
  • Montevallo, AL
  • NPI 1003830134
  Authorized official Same address or phone

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1083638746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 MAIN ST",
            "city": "MONTEVALLO",
            "state": "AL",
            "postal_code": "351153846",
            "telephone_number": "205-665-2031",
            "fax_number": "205-665-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 MAIN ST",
            "city": "MONTEVALLO",
            "state": "AL",
            "postal_code": "351153846",
            "telephone_number": "205-665-2031",
            "fax_number": "205-665-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN A. CRUNK, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "CRUNK",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-665-2031",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF AL PROVIDER #",
            "identifier": "510-03995",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Montevallo, AL
• Providers in Montevallo, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.