Individual provider Active NPI

Sharon M McCreven, RDH

  • Dental Hygienist
  • Orange, CT
National Provider Identifier
1104814052
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
004299 Issued in CT
Practice address
345 Dogburn LN
Orange, CT 06477-3102
Phone
(203) 867-5414
Fax
(203) 789-5912
NPI assigned
Oct 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 004299 CT Primary

Addresses

Primary practice location

345 Dogburn LN
Orange, CT 06477-3102

Mailing address

345 Dogburn LN
Orange, CT 06477-3102
Phone (203) 867-5414

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
004299CTMDGeneral Acute Care Hospital

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104814052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 DOGBURN LN",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773102",
            "telephone_number": "203-867-5414",
            "fax_number": "203-789-5912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 DOGBURN LN",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773102",
            "telephone_number": "203-867-5414",
            "fax_number": "203-789-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCREVEN",
        "first_name": "SHARON",
        "middle_name": "M",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CT",
            "license": "004299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.