Nathaniel Criddle, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6890593-9922 Issued in UT

Practice address

325 Aerospace Medicine SQ/SGPD
340 Magnolia Circle BLDG 1465
Tyndall Afb, FL 32403

Phone

(850) 283-7444

NPI assigned

Feb 23, 2016

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1326408063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 AEROSPACE MEDICINE SQ/SGPD",
            "address_2": "340 MAGNOLIA CIRCLE BLDG 1465",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "32444",
            "telephone_number": "850-283-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 AEROSPACE MEDICINE SQ/SGPD",
            "address_2": "340 MAGNOLIA CIRCLE BLDG 1465",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "32403",
            "telephone_number": "850-283-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIDDLE",
        "first_name": "NATHANIEL",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-23",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "6890593-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Kay Calvin, WHCNP/ANP
• Walter Edward Calvo, DCSW
• Zachary Caleb Camacho, DMD
• David O Campbell, PHARM D
• Matthew Russel Checketts, D.D.S.
• Emily Grace Dietrich, PHARM.D.
• Preston S Duffin, D.D.S, M.S.
• An Thuy Duong, MD
• Lori Elliott, DENTAL HYGIENIST
• Shauna M. Ezell, PHD, LCSW

• General Practice Dentistry in Tyndall Afb, FL
• Providers in Tyndall Afb, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.