Richard W Crawford, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

3428 Issued in ME

Practice address

440 Western Ave
South Portland, ME 04106

Phone

(207) 774-2611

Fax

(207) 774-2613

NPI assigned

Sep 15, 2006

Last updated

Jun 12, 2009By 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

Other identifiers 1

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 Jul 1, 2023 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

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.

• Southern Maine Oral and Maxillofacial Surgery PA

  • Oral and Maxillofacial Surgery (Dentist)
  • South Portland, ME
  • NPI 1831256338
  NPD (past) Authorized official

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244764800000",
    "number": "1174629794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 WESTERN AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-774-2611",
            "fax_number": "207-774-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 WESTERN AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-774-2611",
            "fax_number": "207-774-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "RICHARD",
        "middle_name": "W",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2009-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ME",
            "license": "3428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304020099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Couture, PA
• Covenant Residential Services LLC
• Cheyenne Cox
• Oskar Hale Cox
• Elizabeth Wood Crane, LCSW
• Brenna E. Creamer, PT
• Carrie Joy Crecelius, RN
• Madison Scott Creighton, PA-C
• Gina Marie Criado, RN
• Alyssa Crockett, LMT

• Oral and Maxillofacial Surgery (Dentist) in South Portland, ME
• Providers in South Portland, ME by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; 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.