Individual provider Active NPI

Tyler Andrew Crews, D.M.D.

  • Dentist
  • Saint Louis, MO
National Provider Identifier
1306287495
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2014029153 Issued in MO
Practice address
20 W Lockwood Ave
Saint Louis, MO 63119-2932
Phone
(314) 961-3244
Fax
(866) 670-0945
NPI assigned
Jul 17, 2013
Last updated
May 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2014029153 MO Primary

Addresses

Primary practice location

20 W Lockwood Ave
Saint Louis, MO 63119-2932

Mailing address

20 W Lockwood Ave
Saint Louis, MO 63119-2932
Phone (314) 961-3244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20160609000792 IL Order and Referring Only - DentistPractitioner - Dentist 4981994506

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014029153MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Crews Dental LLC Current Accepting new patients
Crews Dental LLC Current Accepting new patients

Locations

20 W Lockwood Ave
Webster Groves, MO 63119
Phone (314) 961-3244

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1306287495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W LOCKWOOD AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631192932",
            "telephone_number": "314-961-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W LOCKWOOD AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631192932",
            "telephone_number": "314-961-3244",
            "fax_number": "866-670-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREWS",
        "first_name": "TYLER",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-17",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2014029153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.