Christopher Eric Crecelius, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DE00008882 Issued in WA

Practice address

3425 Ensign Rd NE Ste 310
Olympia, WA 98506-5063

Phone

(360) 456-5678

Fax

(360) 456-1238

NPI assigned

Jun 9, 2009

Sex

Male

Sole proprietor

No

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 MD

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

State licenses

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.

• South Sound Ambulatory Surgery Center, PLLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Olympia, WA
  • NPI 1487183000
  NPD
• South Sound Oral Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Centralia, WA
  • NPI 1396830238

  Oral and Maxillofacial Surgery

  NPD (past)
• South Sound Oral Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Olympia, WA
  • NPI 1407944614

  Oral and Maxillofacial Surgery

  NPD (past)
• South Sound Oral Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Dupont, WA
  • NPI 1942581681

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1447486170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E ANDERSON RD",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983828075",
            "telephone_number": "360-683-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 ENSIGN RD NE STE 310",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065063",
            "telephone_number": "360-456-5678",
            "fax_number": "360-456-1238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Station Dr Ste 181",
            "address_purpose": "LOCATION",
            "city": "DuPont",
            "state": "WA",
            "postal_code": "983279777",
            "country_code": "US",
            "telephone_number": "253-579-0000",
            "fax_number": "253-579-0010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1220 W 1st St Ste A",
            "address_purpose": "LOCATION",
            "city": "Centralia",
            "state": "WA",
            "postal_code": "985313018",
            "country_code": "US",
            "telephone_number": "360-736-0715",
            "fax_number": "360-330-5091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRECELIUS",
        "first_name": "CHRISTOPHER",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-09",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE00008882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Olympia, WA
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.