Kelly Crenna, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901022146 Issued in MI

Practice address

450 S Wagner Rd
Ann Arbor, MI 48103-1944

Phone

(734) 668-8420

NPI assigned

Jun 30, 2016

Sex

Female

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

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Crenna, PLLC

  • General Practice Dentistry
  • And Arbor, MI
  • NPI 1861104036
  NPD Authorized official
• Ann Arbor Dental Care, PLLC

  • Prosthodontics
  • Ann Arbor, MI
  • NPI 1972983138

  General Practice

  NPD (past)

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1417308461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S WAGNER RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481031944",
            "telephone_number": "734-668-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S WAGNER RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481031944",
            "telephone_number": "734-668-8420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2316 W Madison St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606122228",
            "country_code": "US",
            "telephone_number": "312-909-9398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRENNA",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901022146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creating Brighter Futures
• Creating Brighter Futures, Inc
• Creative Life Therapy LLC
• Mary Louise Creedon, MD
• Nicole Cremer
• Margaret J Cressman, MSW
• Alison Crew, ATC
• Deborah Ann Crider, NP
• Denise L. Crimaldi, RN NP
• Laurie A Crimando, NP

• Dentist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.