Individual provider Active NPI

Craig Jackson Wright, D.D.S.

  • Dentist
  • Yucaipa, CA
National Provider Identifier
1194882894
Registry record updated Mar 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
34016 Issued in CA
Practice address
33490 Oak Glen Rd Ste F
Yucaipa, CA 92399-2095
Phone
(909) 790-9300
Fax
(909) 797-2600
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 34016 CA Primary
Dentist 122300000X 145483-9922 UT

Addresses

Primary practice location

33490 Oak Glen Rd Ste F
Yucaipa, CA 92399-2095

Mailing address

33490 Oak Glen Rd Ste F
Yucaipa, CA 92399-2095
Phone (909) 790-9300

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

LicenseStateTypeSpecialty
145483-9922UTMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1194882894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33490 OAK GLEN RD STE F",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992095",
            "telephone_number": "909-790-9300",
            "fax_number": "909-797-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33490 OAK GLEN RD STE F",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992095",
            "telephone_number": "909-790-9300",
            "fax_number": "909-797-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "CRAIG",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "34016",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "145483-9922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.