Renner Dental Management LLC.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

134220345 Issued in MD

Legal business name

RENNER DENTAL MANAGEMENT LLC.

Doing business as

Advanced Dental Care LLC.

Practice address

122 N Philadelphia Blvd
Aberdeen, MD 21001-2513

Phone

(410) 272-2636

Fax

(410) 272-8587

NPI assigned

Dec 5, 2008

Last updated

Dec 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kerry Crocken, DDSNPI 1295918837

Title

Owner

Phone

(410) 272-2636

Specialties & licenses 1

Addresses

Other names 1

• Advanced Dental Care LLC. Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kerry Francis Crocken, D.D.S.

  • General Practice Dentistry
  • Aberdeen, MD
  • NPI 1295918837
  Authorized official Same address or phone

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228435200000",
    "number": "1245475243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 N PHILADELPHIA BLVD",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210012513",
            "telephone_number": "410-272-2636",
            "fax_number": "410-272-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 N PHILADELPHIA BLVD",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210012513",
            "telephone_number": "410-272-2636",
            "fax_number": "410-272-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENNER DENTAL MANAGEMENT LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-05",
        "last_updated": "2008-12-05",
        "status": "A",
        "authorized_official_last_name": "CROCKEN",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-272-2636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "134220345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dental Care LLC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Lynn Raab, PT, DPT
• Alphonsa Abdul Rahman, DNP, APRN,CNS, CCRN
• Valerie Lynn Reed, O. D.
• Kristen Reese, LGPC
• Jacquez Reid
• Restorative Health Care LLC
• Brandy M Retallack, LMT, DOULA
• Noreen Richards
• Jillian Ann Richardson, DPT
• Rebecca Jean Rieland, LMSW

• General Practice Dentistry in Aberdeen, MD
• Providers in Aberdeen, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.