Custom Crowns

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

CUSTOM CROWNS

Practice address

5202 Plunkett St
Hollywood, FL 33021-8023

Phone

(754) 581-8402

NPI assigned

Jun 26, 2018

Organization subpart

No

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

Authorized official

Name

Tyshawn MartinNPI 1255963450

Title

Founder/ Ceo

Phone

(305) 788-7779

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyshawn Martin, LPN

  • Licensed Practical Nurse
  • Hollywood, FL
  • NPI 1255963450

  Specialist

  NPD Authorized official

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1205321809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5202 PLUNKETT ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218023",
            "telephone_number": "305-788-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 PLUNKETT ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218023",
            "telephone_number": "754-581-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM CROWNS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "TYSHAWN",
        "authorized_official_title_or_position": "FOUNDER/ CEO",
        "authorized_official_telephone_number": "305-788-7779"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joeneyce Cunningham
• Curley'S House Community Health Network, Inc (CH Community Health)
• Vanessa Renee Curry
• Leonardo Custidiano
• Custody Evaluation Services, Inc.
• Teresa Nicole Cutillo, B.A., SLP-A
• Kallay Elizabeth Cutler, LMHC
• Cy Foot and Ankle Center LLC
• Cynthia Wigutow Rd LLC
• Cypress Place

• Customized Equipment (DME) in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Customized Equipment (DME) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.