Individual provider Active NPI

Lisa S Crafton, D.D.S.

  • General Practice Dentistry
  • Columbia, MD
National Provider Identifier
1548388960
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12228 Issued in MD
Practice address
10380 Old Columbia Rd Ste 102
Columbia, MD 21046-2005
Phone
(410) 381-0900
Fax
(410) 381-7960
NPI assigned
Mar 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12228 MD Primary

Addresses

Primary practice location

10380 Old Columbia Rd Ste 102
Columbia, MD 21046-2005

Mailing address

4231 Leland St
Chevy Chase, MD 20815-6048
Phone (301) 657-7829

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
12228MDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548388960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4231 LELAND ST",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208156048",
            "telephone_number": "301-657-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10380 OLD COLUMBIA RD STE 102",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462005",
            "telephone_number": "410-381-0900",
            "fax_number": "410-381-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAFTON",
        "first_name": "LISA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "12228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.