Justin C. Craighead, DMD, MS

Primary specialty

DentistTaxonomy code 122300000X

License

DN18965 Issued in FL

Practice address

3720 NW 43Rd St
Suite 102
Gainesville, FL 32606-6190

Phone

(352) 372-3600

NPI assigned

Sep 10, 2008

Last updated

Apr 15, 2014By the provider in NPPES

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 10, 2025 through Apr 10, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• TDN Dentistry PLLC

  dba Eastman Craighead Perio & Implants LWR

  • Periodontics
  • Lakewood Ranch, FL
  • NPI 1548986441
  NPD (past)

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1134378516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 NW 43RD ST",
            "address_2": "SUITE 102",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326066190",
            "telephone_number": "352-372-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 NW 43RD ST",
            "address_2": "SUITE 102",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326066190",
            "telephone_number": "352-372-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIGHEAD",
        "first_name": "JUSTIN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-10",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "10035",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebony D Craig
• Kim Craig, ARNP/CNM
• Phylis Brinkman Craig, CNM
• Steven Mitchell Craig II, BCBA
• Steven Mitchell Craig III
• Hughie Carlton Craine III, RPSGT
• Courtney Cramer, PA-C
• Carole Crampton, RRT
• Vanessa Cranford, M.D.
• Michael A Crary, PHD

• Dentist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.