Crystal Crew Finnegan, DDS
Individual provider Active NPI Dentist · Middlesex, NC
NPI 1104873066 · NPPES record last updated Jun 13, 2012
Key facts
- NPI
- 1104873066
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 6023 (NC)
- Practice address
- 11180 E Finch Ave
Middlesex, NC 27557-7440 - Phone
- (252) 235-0491
- Fax
- (252) 235-0497
- NPI assigned
- May 27, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6023 | NC | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6023 | NC | Yes |
Addresses
Primary practice location
11180 E Finch Ave
Middlesex, NC 27557-7440
Mailing address
11180 E Finch Ave
Middlesex, NC 27557-7440
Phone (252) 235-0491
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5919175 | Medicaid | NC |
Other providers in Middlesex, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.