Individual provider Active NPI

Robert M Crittenden, D.M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Joseph, MO
National Provider Identifier
1437144458
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
21835 Issued in OH
Practice address
3109 Frederick Ave
Suite a
Saint Joseph, MO 64506-2911
Phone
(816) 232-2300
Fax
(816) 364-4373
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 21835 OH Primary

Addresses

Primary practice location

3109 Frederick Ave
Suite a
Saint Joseph, MO 64506-2911

Mailing address

3109 Frederick Ave
Suite a
Saint Joseph, MO 64506-2911
Phone (816) 232-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20230811001298 TX Practitioner - Dentist 2264505874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
220OKMDAddiction (Substance Use Disorder) Counselor
21835OHMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Jul 1, 2023 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Jul 1, 2023 Accepting new patients
Northwest Missouri Oral & Maxillofacial Surgeons Oral and Maxillofacial Surgery PastSince Nov 1, 2016 Accepting new patients
Cherokee Nation Past Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1437144458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 FREDERICK AVE",
            "address_2": "SUITE A",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062911",
            "telephone_number": "816-232-2300",
            "fax_number": "816-364-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 FREDERICK AVE",
            "address_2": "SUITE A",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062911",
            "telephone_number": "816-232-2300",
            "fax_number": "816-364-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRITTENDEN",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "21835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.