Evan Ray Crystal, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN124272 Issued in GA

Practice address

138 Oakland Pkwy
Leesburg, GA 31763-7200

Phone

(229) 432-2213

NPI assigned

Jul 17, 2026

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1784246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1295655496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 DAWSON RD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317073362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 OAKLAND PKWY",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317637200",
            "telephone_number": "229-432-2213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Carlton Dr",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "GA",
            "postal_code": "317635652",
            "country_code": "US",
            "telephone_number": "229-435-1726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 W Pope St",
            "address_purpose": "LOCATION",
            "city": "Sylvester",
            "state": "GA",
            "postal_code": "317912030",
            "country_code": "US",
            "telephone_number": "229-776-6431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRYSTAL",
        "first_name": "EVAN",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-17",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN124272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Leesburg, GA
• Providers in Leesburg, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.