Active NPI
Crystal L McIntosh, DDS,MS
- Periodontics
- Washington, DC
National Provider Identifier
1114135548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DEN1000851
- Practice address
- 600 W St NW
Washington DC
Washington, DC 20059-1022 - Phone
- (202) 806-0322
- NPI assigned
- May 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901019380 | MI | |
| Periodontics | 1223P0300X | DEN1000851 | DC | Primary |
Addresses
Primary practice location
600 W St NW
Washington DC
Washington, DC 20059-1022
Mailing address
5304 Illinois Ave NW
Washington, DC 20011-3906
Phone (240) 508-9472
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901019380 | MI | MD | Dentist |
| DEN1000851 | DC | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267660800000",
"number": "1114135548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5304 ILLINOIS AVE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200113906",
"telephone_number": "240-508-9472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 W ST NW",
"address_2": "WASHINGTON DC",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200591022",
"telephone_number": "202-806-0322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTOSH",
"first_name": "CRYSTAL",
"middle_name": "L",
"credential": "DDS,MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2010-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901019380",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "DC",
"license": "DEN1000851",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.