NPIMap

Organization Active NPI

Chad Burtless Creps DDS PC

  • Dentist
  • Adrian, MI
National Provider Identifier
1386869790
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901013725 Issued in MI
Legal business name
CHAD BURTLESS CREPS DDS PC
Practice address
770 Riverside Avenue
Suite 200
Adrian, MI 49221
Phone
(517) 263-9609
Fax
(517) 265-7710
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Chad Burtless Creps, DDSNPI 1487862389
Title
President
Phone
(517) 263-9609

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 2901013725 MI Primary

Addresses

Primary practice location

770 Riverside Avenue
Suite 200
Adrian, MI 49221

Mailing address

770 Riverside Avenue
Suite 200
Adrian, MI 49221
Phone (517) 263-9609

National Provider Directory

National Provider Directory

Locations

770 Riverside Ave
Ste 200
Adrian, MI 49221
Phone (517) 263-9609

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386869790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 RIVERSIDE AVENUE",
            "address_2": "SUITE 200",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "49221",
            "telephone_number": "517-263-9609",
            "fax_number": "517-265-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 RIVERSIDE AVENUE",
            "address_2": "SUITE 200",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "49221",
            "telephone_number": "517-263-9609",
            "fax_number": "517-265-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAD BURTLESS CREPS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURTLESS CREPS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-263-9609",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901013725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.