J. Andrew Craycroft D.M.D. Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6137 Issued in KY

Legal business name

J. ANDREW CRAYCROFT D.M.D. INC.

Practice address

1711 Ashley Cir
Suite 3
Bowling Green, KY 42104-5801

Phone

(270) 781-4997

Fax

(270) 781-8557

NPI assigned

Oct 26, 2011

Last updated

Oct 26, 2011By 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

Janet M. Longest

Title

Office MGR.

Phone

(270) 781-4997

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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.

• J. Andrew Craycroft, D.M.D.

  • General Practice Dentistry
  • Bowling Green, KY
  • NPI 1669517140
  NPD (past)

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1295011880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 ASHLEY CIR",
            "address_2": "SUITE 3",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421045801",
            "telephone_number": "270-781-4997",
            "fax_number": "270-781-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 ASHLEY CIR",
            "address_2": "SUITE 3",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421045801",
            "telephone_number": "270-781-4997",
            "fax_number": "270-781-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. ANDREW CRAYCROFT D.M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-26",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "LONGEST",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MGR.",
        "authorized_official_telephone_number": "270-781-4997"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "6137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "60633DM",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60061371",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCNA DENTAL",
            "identifier": "21062",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iris Medical Group Kentucky LLC
• Julie A. Isaac, MD
• Bridget L Isenberg, M.S., CCC-SLP
• Jataun L Isenhower, APRN
• Erin Lynn Iverson, APRN, FNP-BC
• J. Scott Barbee, DMD, PSC (Pediatric Dentistry of Bowling Green)
• Brittany Ann Jackson, APRN, PMHNP-BC
• Canon Peyton Jackson, BS
• Darlasue Katrice Jackson, SLP
• Dolores Jackson

• General Practice Dentistry in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.