Zachariah Lea Crawford, DMD
Individual provider Active NPI General Practice Dentistry · Hattiesburg, MS
NPI 1194166017 · NPPES record last updated Apr 1, 2016
Key facts
- NPI
- 1194166017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 3692-13MS (MS)
- Practice address
- 47 E Lake Rd
Hattiesburg, MS 39402-7706 - Phone
- (601) 466-9652
- NPI assigned
- Jul 8, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151203002140 | MS | Order and Referring Only - Oral Surgery |
2769782325 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3692-13MS | MS | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3692-13MS | MS | Yes |
Addresses
Primary practice location
47 E Lake Rd
Hattiesburg, MS 39402-7706
Mailing address
47 East Lake Rd
Jackson, MS 39206
Other providers in Hattiesburg, MS
- Crawford & Crawford Counseling
- Deena Lambert Crawford
- Everett Howell Crawford Jr.
- Ted Jeffery Crawford
- Virginia Crawford
- Creative Mobilities, LLC
- Brittany Creel
- Cronin Family Dentistry PA
- Christopher Kelly Cronin
- Joseph Michael Cronin
All providers in Hattiesburg, MS · General Practice Dentistry in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.