Individual provider Active NPI

David W. Croxton, D.M.D.

  • Dentist
  • Marietta, GA
National Provider Identifier
1205181641
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10722 Issued in GA
Practice address
1001 Whitlock Ave SW
Suite a
Marietta, GA 30064-1944
Phone
(770) 428-5959
Fax
(770) 421-2168
NPI assigned
Jul 23, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10722 GA Primary

Addresses

Primary practice location

1001 Whitlock Ave SW
Suite a
Marietta, GA 30064-1944

Mailing address

1001 Whitlock Ave SW
Suite a
Marietta, GA 30064-1944
Phone (770) 428-5959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150622002037 GA Order and Referring Only - DentistPractitioner - Dentist 8123339892

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10722GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Croxton Dental LLC CurrentSince Feb 25, 2024 Accepting new patients
West Cobb Dental Group Past Accepting new patients

Locations

1001 Whitlock Ave SW
Ste A
Marietta, GA 30064
Phone (770) 428-5959

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.

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1205181641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 WHITLOCK AVE SW",
            "address_2": "SUITE A",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641944",
            "telephone_number": "770-428-5959",
            "fax_number": "770-421-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WHITLOCK AVE SW",
            "address_2": "SUITE A",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641944",
            "telephone_number": "770-428-5959",
            "fax_number": "770-421-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROXTON",
        "first_name": "DAVID",
        "middle_name": "W.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-23",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "10722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.