Active NPI
Joseph Edward Creasy Jr., DDS
- Endodontics
- Weatherford, TX
National Provider Identifier
1194705624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 27768
- Practice address
- 1429 Clear Lake Rd
Suite 600
Weatherford, TX 76086-5895 - Phone
- (817) 599-4839
- Fax
- (817) 594-5206
- NPI assigned
- Jan 19, 2006
- Last updated
- Jul 2, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0021775 | TX | |
| Endodontics | 1223E0200X | 27768 | TX | Primary |
Addresses
Primary practice location
1429 Clear Lake Rd
Suite 600
Weatherford, TX 76086-5895
Mailing address
1429 Clear Lake Rd
Suite 600
Weatherford, TX 76086-5895
Phone (817) 599-4839
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 |
|---|---|---|---|
| 27768 | TX | MD | Endodontist |
| 0021775 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341187200000",
"number": "1194705624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1429 CLEAR LAKE RD",
"address_2": "SUITE 600",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760865895",
"telephone_number": "817-599-4839",
"fax_number": "817-594-5206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1429 CLEAR LAKE RD",
"address_2": "SUITE 600",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760865895",
"telephone_number": "817-599-4839",
"fax_number": "817-594-5206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CREASY",
"first_name": "JOSEPH",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2012-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "0021775",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "TX",
"license": "27768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weatherford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.