Joseph Allan Craddock, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

048125 Issued in NY

Practice address

3325 E Main Street Rd
Attica, NY 14011

Phone

(585) 591-1404

Fax

(585) 591-2614

NPI assigned

Oct 4, 2006

Last updated

Aug 15, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1275629875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 E. MAIN STREET",
            "city": "ATTICA",
            "state": "NY",
            "postal_code": "14011",
            "telephone_number": "585-591-3509",
            "fax_number": "585-591-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 E MAIN STREET RD",
            "city": "ATTICA",
            "state": "NY",
            "postal_code": "14011",
            "telephone_number": "585-591-1404",
            "fax_number": "585-591-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRADDOCK",
        "first_name": "JOSEPH",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tomi J Burton, LPN
• Michelle Carpenter, PA-C
• Jennifer Caudill
• Meghan Conway
• Tracie A Cooley, RN
• Maria Lynn Cunningham, RD
• William Dawson, D.D.S.
• Jacquelin Victoria Deatcher, NP, CDE
• Melissa M Dispenza
• Erin Jessica Dressel, MS.PT

• General Practice Dentistry in Attica, NY
• Providers in Attica, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.