Active NPI
Elizabeth Shonda Crowder, DMD
- General Practice Dentistry
- Charlotte, NC
National Provider Identifier
1477624096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 30-022163
- Practice address
- 5725 Carnegie Blvd Apt 163
Charlotte, NC 28209-4873 - Phone
- (973) 207-4597
- NPI assigned
- Nov 13, 2006
- Last updated
- Dec 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30-022163 | OH | Primary |
Addresses
Primary practice location
5725 Carnegie Blvd Apt 163
Charlotte, NC 28209-4873
Mailing address
5725 Carnegie Blvd Apt 163
Charlotte, NC 28209-4873
Phone (973) 207-4597
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 |
|---|---|---|---|
| 30-022163 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576713600000",
"number": "1477624096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5725 CARNEGIE BLVD APT 163",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282094873",
"telephone_number": "973-207-4597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5725 CARNEGIE BLVD APT 163",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282094873",
"telephone_number": "973-207-4597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROWDER",
"first_name": "ELIZABETH",
"middle_name": "SHONDA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2019-12-19",
"certification_date": "2019-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30-022163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.