Individual provider Active NPI

Gary S Crosson, DMD

  • General Practice Dentistry
  • Defuniak Springs, FL
National Provider Identifier
1265440028
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN0008852 Issued in FL
Practice address
362 State Highway 83
Defuniak Springs, FL 32433-3800
Phone
(850) 892-8015
Fax
(850) 892-8024
NPI assigned
Aug 4, 2006
Last updated
Mar 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN0008852 FL Primary

Addresses

Primary practice location

362 State Highway 83
Defuniak Springs, FL 32433-3800

Mailing address

362 Highway 83 N
Defuniak Springs, FL 32433-3800
Phone (850) 892-8015

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
DN0008852FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1265440028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 HIGHWAY 83 N",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324333800",
            "telephone_number": "850-892-8015",
            "fax_number": "850-892-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 STATE HIGHWAY 83",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324333800",
            "telephone_number": "850-892-8015",
            "fax_number": "850-892-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSON",
        "first_name": "GARY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0008852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Defuniak Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.