Individual provider Active NPI

David Herman Crowder, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bartlett, TN
National Provider Identifier
1205188109
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D.S.0000002728 Issued in TN
Practice address
6597 Summer Knoll Cove
Bartlett, TN 38134
Phone
(901) 382-8611
Fax
(901) 382-8685
NPI assigned
Oct 3, 2012
Last updated
Oct 3, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D.S.0000002728 TN Primary

Addresses

Primary practice location

6597 Summer Knoll Cove
Bartlett, TN 38134

Mailing address

6597 Summer Knoll Cove
Bartlett, TN 38134
Phone (901) 382-8611

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
D.S.0000002728TNMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1205188109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6597 SUMMER KNOLL COVE",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "38134",
            "telephone_number": "901-382-8611",
            "fax_number": "901-382-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6597 SUMMER KNOLL COVE",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "38134",
            "telephone_number": "901-382-8611",
            "fax_number": "901-382-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWDER",
        "first_name": "DAVID",
        "middle_name": "HERMAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "D.S.0000002728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.

Verify at the official NPI Registry.