Raymond a. Crisio, D.M.D. PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RAYMOND A. CRISIO, D.M.D. PC

Practice address

305 Broad
Evansville, IL 62242-0019

Phone

(618) 853-2215

Fax

(618) 853-2595

NPI assigned

May 5, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Raymond A. Crisio, DMD

Title

Owner

Phone

(618) 853-2215

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Raymond a Crisio DMD PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Frank Scott Parkway PC

  • Dentist
  • Swansea, IL
  • NPI 1235357039
  NPD tax ID
• Raymond a. Crisio DMD PC

  • General Practice Dentistry
  • Evansville, IL
  • NPI 1083024640
  NPD tax ID

Locations

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1104236769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4933 BENCHMARK CENTRE DR",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622268927",
            "telephone_number": "618-632-4003",
            "fax_number": "618-632-4073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 BROAD",
            "city": "EVANSVILLE",
            "state": "IL",
            "postal_code": "622420019",
            "telephone_number": "618-853-2215",
            "fax_number": "618-853-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND A. CRISIO, D.M.D. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "CRISIO",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-853-2215",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113052",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Autumn Gleich, MOT, OTR/L
• Progressive Housing, Inc.
• Raymond a. Crisio DMD PC

• All providers in Evansville, IL
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.