Alicja McCrudden, D.D.S

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

050823 Issued in NY

Practice address

523 Townline Rd Ste 11
Hauppauge, NY 11788-2827

Phone

(631) 265-4442

NPI assigned

Aug 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219795200000",
    "number": "1164435434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11045 QUEENS BLVD",
            "address_2": "APT. #101",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755501",
            "telephone_number": "631-793-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 TOWNLINE RD STE 11",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882827",
            "telephone_number": "631-265-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRUDDEN",
        "first_name": "ALICJA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2008-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "050823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikeisha Lywanda McAnuff, LSW
• Kelsey McAuliffe
• Shannon R McCaffrey
• Julia Marie McCarthy
• Lauren Marie McCarthy
• Marian Theresa McDermott-Webster, NURSE PRACTITIONER
• Meaghan McDonough
• Kathleen Marie McElhone, NP
• Jack Albert McEnroe
• Stephanie A McGeachy, OTRL

• Periodontics in Hauppauge, NY
• Providers in Hauppauge, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.