Individual provider Active NPI

Daniel Crossen, DMD

  • Dentist
  • Lakewood, WA
National Provider Identifier
1497038657
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60235923 Issued in WA
Practice address
5422 74TH St W Ste C
Lakewood, WA 98499-7900
Phone
(253) 475-9120
NPI assigned
Sep 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60235923 WA Primary

Addresses

Primary practice location

5422 74TH St W Ste C
Lakewood, WA 98499-7900

Mailing address

5422 74TH St W Ste C
Lakewood, WA 98499-7900
Phone (253) 475-9120

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

LicenseStateTypeSpecialty
DE60235923WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Ridge Endodontics CurrentSince May 11, 2025 Accepting new patients

Locations

689 Emory Valley Rd
Ste 101
Oak Ridge, TN 37830
Phone (865) 978-6546

Organizations & group practices 1

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": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1497038657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5422 74TH ST W STE C",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984997900",
            "telephone_number": "253-475-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5422 74TH ST W STE C",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984997900",
            "telephone_number": "253-475-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSEN",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-23",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60235923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.