Individual provider Active NPI

Cameron Critchfield, DDS

  • General Practice Dentistry
  • Cody, WY
National Provider Identifier
1104213636
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1446 Issued in WY
Practice address
1531 Bleistein Ave
Cody, WY 82414-3806
Phone
(307) 587-0100
Fax
(307) 587-0105
NPI assigned
Apr 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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 1446 WY Primary

Addresses

Primary practice location

1531 Bleistein Ave
Cody, WY 82414-3806

Mailing address

26 South 2000 East, Suite 5900
Salt Lake City, UT 84112
Phone (801) 581-8951

Other practice location 1

1045 N 27th St
Billings, MT 59101-0711
Phone (406) 245-7026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1446WYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Yellowstone Family Dental General Practice PastSince Jan 3, 2021 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": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1104213636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SOUTH 2000 EAST, SUITE 5900",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84112",
            "telephone_number": "801-581-8951",
            "fax_number": "801-585-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 BLEISTEIN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143806",
            "telephone_number": "307-587-0100",
            "fax_number": "307-587-0105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1045 N 27th St",
            "address_purpose": "LOCATION",
            "city": "Billings",
            "state": "MT",
            "postal_code": "591010711",
            "country_code": "US",
            "telephone_number": "406-245-7026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRITCHFIELD",
        "first_name": "CAMERON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-22",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cody, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.