Individual provider Active NPI

Sharon Bowers McCrary, D.M.D.

  • General Practice Dentistry
  • South Daytona, FL
National Provider Identifier
1295819480
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13432 Issued in FL
Practice address
3231 S Ridgewood Ave
South Daytona, FL 32119-3561
Phone
(386) 788-9599
Fax
(386) 788-9895
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 13432 FL Primary

Addresses

Primary practice location

3231 S Ridgewood Ave
South Daytona, FL 32119-3561

Mailing address

3231 S Ridgewood Ave
South Daytona, FL 32119-3561
Phone (386) 788-9599

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
13432FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295819480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 S RIDGEWOOD AVE",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193561",
            "telephone_number": "386-788-9599",
            "fax_number": "386-788-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 S RIDGEWOOD AVE",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193561",
            "telephone_number": "386-788-9599",
            "fax_number": "386-788-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRARY",
        "first_name": "SHARON",
        "middle_name": "BOWERS",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "13432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.