Misty McCurry Crump, D.D.S.
Individual provider Active NPI Dentist · Shreveport, LA
NPI 1568640464 · NPPES record last updated Feb 4, 2008
Key facts
- NPI
- 1568640464
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 5793 (LA)
- Practice address
- 8938 Kingston Rd
Shreveport, LA 71118-2730 - Phone
- (318) 686-3899
- Fax
- (318) 686-3997
- NPI assigned
- Feb 4, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective May 2, 2016 through May 2, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5793 | LA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Benton Family Dentistry LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5793 | LA | Yes |
Addresses
Primary practice location
8938 Kingston Rd
Shreveport, LA 71118-2730
Mailing address
8938 Kingston Rd
Shreveport, LA 71118-2730
Phone (318) 686-3899
Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.