Cre8Tive Pediatric Dental Group

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CRE8TIVE PEDIATRIC DENTAL GROUP

Practice address

2201 Fort Worth Avenue
Dallas, TX 75211

Phone

(972) 544-7524

NPI assigned

Feb 13, 2020

Last updated

Feb 13, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jessica Marshall, DDSNPI 1841425394

Title

Pediatric Dentist/Owner

Phone

(972) 544-7524

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Jessica Morran Marshall, DDS

  • Pediatric Dentistry
  • Houston, TX
  • NPI 1841425394
  Authorized official Same address or phone

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1447883863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2787 N HOUSTON ST APT 4002",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752195042",
            "telephone_number": "281-935-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 FORT WORTH AVENUE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75211",
            "telephone_number": "972-544-7524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRE8TIVE PEDIATRIC DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST/OWNER",
        "authorized_official_telephone_number": "972-544-7524",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841425394",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Crawford, PT, DPT
• Shawana M Crawford, MSN-NP
• Shellye Elaine Crawford, CPNP
• Tricia Reiko Crawford, CRNA
• Venus Crawford
• Mary S Creagan, RN CRNA
• Susan M Creagan, M.D.
• Latisha Creagh, LCSW
• Peggy Kay Creasy, PAC
• Creating Harmony

• Pediatric Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.