Brian E. Crock DDS Ms Inc

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

BRIAN E. CROCK DDS MS INC

Practice address

175 McMillen Dr
Newark, OH 43055-1810

Phone

(740) 344-3372

NPI assigned

Apr 8, 2008

Organization subpart

No

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

Authorized official

Name

Brian E Crock, DDS, MSNPI 1366413528

Title

President

Phone

(740) 344-3372

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Brian E Crock, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Newark, OH
  • NPI 1366413528
  NPD (past) Authorized official

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1215100698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 MCMILLEN DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551810",
            "telephone_number": "740-344-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MCMILLEN DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551810",
            "telephone_number": "740-344-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN E. CROCK DDS MS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "CROCK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-344-3372",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0970436",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia E Bradford, LICDC
• Deborah Jo Bradley, RN
• Judson Carlton Brandenburg
• Trevor Arthur Braukman, LCDCIII
• Carrie Lynn Brehm, PA-C
• Andrea M Bridges
• Sarah Brink
• Sarah Brocker, ED.S.
• Matthew Craig Bromley, D.O.
• Evan Miles Brookbank

• Orthodontics and Dentofacial Orthopedics Dentistry in Newark, OH
• Providers in Newark, OH by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.