Individual provider Active NPI

Richard Lee Cross, DDS MS

  • Pediatric Dentistry
  • Lexington, SC
National Provider Identifier
1487720793
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
1729-0154PD Issued in SC
Practice address
139 Whiteford Way
Lexington, SC 29072-7965
Phone
(803) 951-9100
Fax
(803) 951-1910
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 1729-0154PD SC Primary

Addresses

Primary practice location

139 Whiteford Way
Lexington, SC 29072-7965

Mailing address

139 Whiteford Way
Lexington, SC 29072-7965
Phone (803) 951-9100

Other identifiers 1

IdentifierTypeStateIssuer
Z17296MedicaidSC

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1729-0154PDSCMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Children's Dental Center, LLC Past Accepting new patients
Palmetto Smiles Dentistry Partnership Pediatric Dentistry Past Accepting new patients

Organizations & group practices 2

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1487720793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 WHITEFORD WAY",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727965",
            "telephone_number": "803-951-9100",
            "fax_number": "803-951-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 WHITEFORD WAY",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727965",
            "telephone_number": "803-951-9100",
            "fax_number": "803-951-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSS",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "1729-0154PD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z17296",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.