A Beautiful Smile Means a Better Life 3

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20092 Issued in CA

Legal business name

A BEAUTIFUL SMILE MEANS A BETTER LIFE 3

Practice address

5512 Britton Dr Ste 208
Long Beach, CA 90815

Phone

(562) 430-2740

Fax

(562) 430-0466

NPI assigned

May 9, 2008

Last updated

May 9, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gary R Crockett, DDS

Title

Owner

Phone

(562) 430-2740

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1356518310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 BRITTON DR STE 208",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90815",
            "telephone_number": "562-430-2740",
            "fax_number": "562-430-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5512 BRITTON DR STE 208",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90815",
            "telephone_number": "562-430-2740",
            "fax_number": "562-430-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A BEAUTIFUL SMILE MEANS A BETTER LIFE 3",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "CROCKETT",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-430-2740",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "20092",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50687",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Long Beach, CA
• Providers in Long Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.