Active NPI
Precious Laverne Crawford, DDS
- General Practice Dentistry
- Decatur, GA
National Provider Identifier
1467528562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN010948
- Practice address
- 3604 John Carrol Dr
Decatur, GA 30034-5600 - Phone
- (404) 218-9200
- Fax
- (000) 000-0000
- NPI assigned
- Nov 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN010948 | GA | |
| General Practice Dentistry | 1223G0001X | DN010948 | GA | Primary |
Addresses
Primary practice location
3604 John Carrol Dr
Decatur, GA 30034-5600
Mailing address
3604 John Carrol Dr
Decatur, GA 30034-5600
Phone (404) 218-9200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 582398245 | Other | GA | TAX ID |
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 |
|---|---|---|---|
| DN010948 | GA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1467528562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3604 JOHN CARROL DR",
"city": "DECATUR",
"state": "GA",
"postal_code": "300345600",
"telephone_number": "404-218-9200",
"fax_number": "000-000-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3604 JOHN CARROL DR",
"city": "DECATUR",
"state": "GA",
"postal_code": "300345600",
"telephone_number": "404-218-9200",
"fax_number": "000-000-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAWFORD",
"first_name": "PRECIOUS",
"middle_name": "LAVERNE",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-28",
"last_updated": "2022-12-21",
"certification_date": "2022-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "GA",
"license": "DN010948",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN010948",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "582398245",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.