Individual provider Active NPI

Marc Donald Crosby, DDS

  • General Practice Dentistry
  • Laguna Hills, CA
National Provider Identifier
1104090398
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33740 Issued in CA
Practice address
25411 Cabot Rd Ste 108
Laguna Hills, CA 92653-5517
Phone
(949) 951-1066
Fax
(949) 951-6425
NPI assigned
Apr 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 33740 CA Primary

Addresses

Primary practice location

25411 Cabot Rd Ste 108
Laguna Hills, CA 92653-5517

Mailing address

25411 Cabot Rd Ste 108
Laguna Hills, CA 92653-5517
Phone (949) 951-1066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160526001197 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1557651908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aliso Hills Dental Associates General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1104090398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25411 CABOT RD STE 108",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535517",
            "telephone_number": "949-951-1066",
            "fax_number": "949-951-6425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25411 CABOT RD STE 108",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535517",
            "telephone_number": "949-951-1066",
            "fax_number": "949-951-6425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSBY",
        "first_name": "MARC",
        "middle_name": "DONALD",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-17",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.