Lance David Crowther, DDS PC
Individual provider Active NPI Dentist · Morgan, UT
NPI 1376640391 · NPPES record last updated Dec 4, 2024
Key facts
- NPI
- 1376640391
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 5129696 (UT)
- Practice address
- 195 E 100 N
Morgan, UT 84050-0721 - Phone
- (801) 829-6471
- Fax
- (801) 829-6475
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- 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 |
|---|---|---|---|---|
| I20151214002340 | UT | Order and Referring Only - Dentist |
9830490903 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lance D Crowther DDS PC | Dentist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5129696 | UT | Yes |
Addresses
Primary practice location
195 E 100 N
Morgan, UT 84050-0721
Mailing address
PO Box 721
Morgan, UT 84050-0721
Phone (801) 829-6471
Other providers in Morgan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2024. 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.