Timothy F. Crisp, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

6359 Issued in KY

Practice address

11 Canary LN
Winchester, KY 40391-1645

Phone

(859) 744-7031

Fax

(859) 744-9175

NPI assigned

Feb 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Crisp Dre LLC

  • Pediatric Dentistry
  • Winchester, KY
  • NPI 1902671373
  NPD (past)
• Tim F. Crisp DMD

  • Dentist
  • Winchester, KY
  • NPI 1144469016
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1275671208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CANARY LN",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911645",
            "telephone_number": "859-744-7031",
            "fax_number": "859-744-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CANARY LN",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911645",
            "telephone_number": "859-744-7031",
            "fax_number": "859-744-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISP",
        "first_name": "TIMOTHY",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "6359",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "6359",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "6359",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60063591",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elmer Cox II
• Tammy Rena Cox
• Nathan Tyler Coyle
• Billy Joe Craig, DMD
• Crisp Dre LLC
• Haley Crowe
• Caitlin Nicole Crump, ATC, LAT
• Dustin Cundiff, DO
• Joy Beth Curtis, PSYD
• Faith Nicole Dalrymple, M.A. CF-SLP

• Pediatric Dentistry in Winchester, KY
• Providers in Winchester, KY by specialty
• Pediatric Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.