Active NPI
Patrick C. Creevan, D.D.S.
- Pediatric Dentistry
- Livermore, CA
National Provider Identifier
1427263276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 47706
- Practice address
- 1964 Fourth Street
Livermore, CA 94550-4163 - Phone
- (925) 443-5980
- Fax
- (925) 294-9083
- NPI assigned
- May 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 47706 | CA | Primary |
Addresses
Primary practice location
1964 Fourth Street
Livermore, CA 94550-4163
Mailing address
1964 Fourth Street
Livermore, CA 94550-4163
Phone (925) 443-5980
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
| License | State | Type | Specialty |
|---|---|---|---|
| 47706 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Patrick C. Creevan, D.D.S., Inc. | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Livermore, CA
- NPI 1770798423
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333584000000",
"number": "1427263276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1964 FOURTH STREET",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945504163",
"telephone_number": "925-443-5980",
"fax_number": "925-294-9083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1964 FOURTH STREET",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945504163",
"telephone_number": "925-443-5980",
"fax_number": "925-294-9083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CREEVAN",
"first_name": "PATRICK",
"middle_name": "C.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2012-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "47706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livermore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.