Wyatt Allen Crowell, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.027244 Issued in OH

Practice address

9305 Market Square Dr
Streetsboro, OH 44241-5294

Phone

(330) 422-0011

NPI assigned

Jun 9, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ohio Dental Professionals, Delisle, P.C.

  • General Practice Dentistry
  • Streetsboro, OH
  • NPI 1801387972
  NPD (past)

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1124757554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 BISSONNET ST APT 3143",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770051365",
            "telephone_number": "614-557-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9305 MARKET SQUARE DR",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415294",
            "telephone_number": "330-422-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWELL",
        "first_name": "WYATT",
        "middle_name": "ALLEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-09",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38505",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.027244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steve J Cigany Jr.
• City of Streetsboro
• Lauren Clark, LISW
• Close to Home Nursing Care and Rehab
• Stephane C Cross, RN
• Bailee R D'Amore-Dicamillo
• Jeffrey Mark Danczak, D.M.D
• Susan E Daris, O.D.
• Hanna Darling, OTR/L
• Jaymini D Dave

• General Practice Dentistry in Streetsboro, OH
• Providers in Streetsboro, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.