Edward Anthony Cronauer IV, DMD, MDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN20617 Issued in FL

Practice address

327 Central Ave
Clewiston, FL 33440-3716

Phone

(863) 983-5121

NPI assigned

Jul 8, 2014

Last updated

Oct 22, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1164838454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 CENTRAL AVE",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334403716",
            "telephone_number": "863-983-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 CENTRAL AVE",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334403716",
            "telephone_number": "863-983-5121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 S Main St Ste 2B",
            "address_purpose": "LOCATION",
            "city": "LaBelle",
            "state": "FL",
            "postal_code": "339354956",
            "country_code": "US",
            "telephone_number": "863-675-2011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "349 NW 16th St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Belle Glade",
            "state": "FL",
            "postal_code": "334302839",
            "country_code": "US",
            "telephone_number": "561-996-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRONAUER",
        "first_name": "EDWARD",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DMD, MDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-08",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN20617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Clewiston, FL
• Providers in Clewiston, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.