Individual provider Active NPI

Crista Fantone

  • Dentist
  • Liverpool, NY
National Provider Identifier
1386182277
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0160133869 Issued in VT
Practice address
5100 W Taft Rd Ste 3K
Liverpool, NY 13088-3809
Phone
(315) 760-7777
NPI assigned
Feb 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 065125 NY
Dentist 122300000X 0160133869 VT Primary

Addresses

Primary practice location

5100 W Taft Rd Ste 3K
Liverpool, NY 13088-3809

Mailing address

PO Box 320
Plainfield, VT 05667-0320
Phone (802) 454-8336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20220127002155 VT Practitioner - Dentist 2567854383 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
065125NYMDDentist
0160133869VTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Washington County Community Health, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Northeast Washington County Community Health Inc CurrentSince Oct 1, 2021 Accepting new patients

Locations

157 Towne Ave
Plainfield, VT 05667
Phone (802) 322-6613

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1386182277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320",
            "city": "PLAINFIELD",
            "state": "VT",
            "postal_code": "056670320",
            "telephone_number": "802-454-8336",
            "fax_number": "802-454-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD STE 3K",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883809",
            "telephone_number": "315-760-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTONE",
        "first_name": "CRISTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-10",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "065125",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "0160133869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.