Tyler Andrew Crews, D.M.D.
Individual provider Active NPI Dentist · Saint Louis, MO
NPI 1306287495 · NPPES record last updated May 26, 2021
Key facts
- NPI
- 1306287495
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2014029153 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160609000792 | IL | Order and Referring Only - Dentist |
4981994506 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014029153 | MO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crews Dental LLC | Current |
Accepting new patients | |
| Crews Dental LLC | Current | Accepting new patients | |
| Kurt a. Weisenfels, DDS, PC | Past |
Accepting new patients |
Locations
20 W Lockwood Ave
Webster Groves, MO 63119
Phone (314) 961-3244
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2014029153 | MO | Yes |
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
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.