Organization Active NPI

Lytle Family Dentistry & Orthodontics

  • General Practice Dentistry
  • Lytle, TX
National Provider Identifier
1427730357
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LYTLE FAMILY DENTISTRY & ORTHODONTICS
Practice address
14739 Main Street
Lytle, TX 78052
Phone
(830) 772-4567
Fax
(830) 772-9804
NPI assigned
Aug 1, 2023
Last updated
Aug 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Authorized official

Name
Justin Jay Crocker, DDS
Title
Dentist
Phone
(830) 772-4567

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

14739 Main Street
Lytle, TX 78052

Mailing address

14739 Main Street
Lytle, TX 78052
Phone (830) 772-4567

National Provider Directory

National Provider Directory

Locations

14739 Main St
Lytle, TX 78052
Phone (830) 772-4567

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1427730357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14739 MAIN STREET",
            "city": "LYTLE",
            "state": "TX",
            "postal_code": "78052",
            "telephone_number": "830-772-4567",
            "fax_number": "830-772-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14739 MAIN STREET",
            "city": "LYTLE",
            "state": "TX",
            "postal_code": "78052",
            "telephone_number": "830-772-4567",
            "fax_number": "830-772-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYTLE FAMILY DENTISTRY & ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-01",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "CROCKER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "830-772-4567",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lytle, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.