Active NPI
Crystal Lynn Pursche, DDS
- General Practice Dentistry
- Beachwood, OH
National Provider Identifier
1174251987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 30.027995
- Practice address
- PO Box 22108
Beachwood, OH 44122-0108 - Phone
- (817) 714-7784
- NPI assigned
- Aug 10, 2022
- Last updated
- Sep 12, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 38419 | TX | |
| General Practice Dentistry | 1223G0001X | 30.027995 | OH | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | CT |
Addresses
Primary practice location
PO Box 22108
Beachwood, OH 44122-0108
Mailing address
PO Box 22108
Beachwood, OH 44122-0108
Other practice location 1
2020 Pleasanton Rd
San Antonio, TX 78221-1305
Phone (210) 922-2765
Other practice location 2
3715 SW Military Dr
San Antonio, TX 78211-3514
Phone (210) 532-1166
Other practice location 3
80 Seymour St
Hartford, CT 06102-8000
Phone (860) 972-2700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.027995 | OH | MD | General Practice Dentistry |
| 38419 | TX | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Campos Family Dental PC | General Practice | Past | Accepting new patients |
| Campos Family Dental, P.C. | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- San Antonio, TX
- NPI 1336301498
-
- General Practice Dentistry
- San Antonio, TX
- NPI 1417489634
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757635200000",
"number": "1174251987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22108",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441220108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 22108",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441220108",
"telephone_number": "817-714-7784"
}
],
"practiceLocations": [
{
"address_1": "2020 Pleasanton Rd",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782211305",
"country_code": "US",
"telephone_number": "210-922-2765",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3715 SW Military Dr",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782113514",
"country_code": "US",
"telephone_number": "210-532-1166",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "80 Seymour St",
"address_purpose": "LOCATION",
"city": "Hartford",
"state": "CT",
"postal_code": "061028000",
"country_code": "US",
"telephone_number": "860-972-2700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PURSCHE",
"first_name": "CRYSTAL",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-10",
"last_updated": "2025-09-12",
"certification_date": "2025-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "38419",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30.027995",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CT",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beachwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.