Individual provider Active NPI

Jeffrey Steven Crowley, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • West Linn, OR
National Provider Identifier
1255777330
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D10814 Issued in OR
Practice address
22400 Salamo Rd Ste 205
West Linn, OR 97068-8269
Phone
(503) 657-8787
NPI assigned
May 16, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2013020368 MO
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X D10814 OR Primary

Addresses

Primary practice location

22400 Salamo Rd Ste 205
West Linn, OR 97068-8269

Mailing address

22400 Salamo Rd Ste 205
West Linn, OR 97068-8269
Phone (503) 657-8787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160122001669 MO Practitioner - Oral Surgery 8022311182 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D10814ORMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Swope Health Services CurrentSince Dec 16, 2015 Accepting new patients
Swope Health Services CurrentSince Dec 16, 2015 Accepting new patients
Oral Solutions NW Current Accepting new patients
Swope Health Services Single Specialty Current Accepting new patients

Locations

17844 E 23rd St S
Independence, MO 64057
Phone (816) 257-9716

3801 Dr Martin Luther King Jr Blvd
Kansas City, MO 64130
Phone (816) 599-5500

22400 Salamo Rd
Ste 205
West Linn, OR 97068
Phone (503) 657-8787

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1255777330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22400 SALAMO RD STE 205",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970688269",
            "telephone_number": "503-657-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22400 SALAMO RD STE 205",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970688269",
            "telephone_number": "503-657-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWLEY",
        "first_name": "JEFFREY",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2013020368",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D10814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Linn, OR

Sources for this page

Verify at the official NPI Registry.