Individual provider Active NPI

Craig Allen Flickinger, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Wright Patterson Afb, OH
National Provider Identifier
1417948001
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2901014405 Issued in MI
Practice address
4881 Sugar Maple Dr
88MDG/SGDD
Wright Patterson Afb, OH 45433-5546
Phone
(937) 257-9585
Fax
(937) 656-1130
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2901014405 MI Primary

Addresses

Primary practice location

4881 Sugar Maple Dr
88MDG/SGDD
Wright Patterson Afb, OH 45433-5546

Mailing address

832 Pearson Rd
Wright Patterson Afb, OH 45433-1160
Phone (937) 879-7674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901014405MIMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417948001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 PEARSON RD",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454331160",
            "telephone_number": "937-879-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "address_2": "88MDG/SGDD",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335546",
            "telephone_number": "937-257-9585",
            "fax_number": "937-656-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLICKINGER",
        "first_name": "CRAIG",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "2901014405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wright Patterson Afb, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.