Benjamin David Crockett, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

25803 Issued in MT

Practice address

6360 US Highway 93 S
Whitefish, MT 59937-8235

Phone

(406) 892-2104

Fax

(406) 892-1422

NPI assigned

Oct 30, 2007

Last updated

Mar 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in OR

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Columbia Falls Family Dental Center PC

  dba Smile Montana Dental Center @ Whitefish

  • General Practice Dentistry
  • Whitefish, MT
  • NPI 1649818808
  NPD
• Columbia Falls Family Dental Center PC

  dba Smile Montana Dental Center

  • General Practice Dentistry
  • Columbia Falls, MT
  • NPI 1508145913
  NPD (past)
• Smile Montana Dental Group PLLC

  dba Smile Montana Dental Center

  • General Practice Dentistry
  • Columbia Falls, MT
  • NPI 1457156374
  NPD (past)

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1164601738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 US HIGHWAY 93 S",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599378235",
            "telephone_number": "406-892-2104",
            "fax_number": "406-892-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 US HIGHWAY 93 S",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599378235",
            "telephone_number": "406-892-2104",
            "fax_number": "406-892-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "BENJAMIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-30",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MT",
            "license": "25803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Cooney, LMT
• Faith Ann Corpron, LMT
• Timothy Scott Corson, PSY.D.
• Victoria Lynne Creighton, PSYD
• Lauren Christine Marie Crittenden, MA
• Sierra Marie Crockford, PT
• Cycles of Life PLLC
• Jeff A Dalen, DDS
• Shelby Swant Damaskos
• Suzanne Daniell

• Dentist in Whitefish, MT
• Providers in Whitefish, MT by specialty
• Dentist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.