NPIMap

Organization Active NPI

Clinton Crawford DDS LLC

Doing business as Fenton Family Dental

  • Dentist
  • Clinton, MD
National Provider Identifier
1568895613
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14056 Issued in MD
Legal business name
CLINTON CRAWFORD DDS LLC
Doing business as
Fenton Family Dental
Practice address
8913 Woodyard Rd
B
Clinton, MD 20735-4257
Phone
(301) 363-2336
Fax
(301) 363-2317
NPI assigned
Aug 13, 2013
Last updated
Aug 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Authorized official

Name
Kyiah D Gill, MPH
Title
Office Manager
Phone
(240) 839-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14056 MD Primary

Addresses

Primary practice location

8913 Woodyard Rd
B
Clinton, MD 20735-4257

Mailing address

8913 Woodyard Rd
B
Clinton, MD 20735-4257
Phone (301) 363-2336

Other names 1

  • FENTON FAMILY DENTAL Doing business as

National Provider Directory

National Provider Directory

Locations

8913 Woodyard Rd
#B
Clinton, MD 20735
Phone (301) 363-2336

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1568895613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8913 WOODYARD RD",
            "address_2": "B",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354257",
            "telephone_number": "301-363-2336",
            "fax_number": "301-363-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8913 WOODYARD RD",
            "address_2": "B",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354257",
            "telephone_number": "301-363-2336",
            "fax_number": "301-363-2317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON CRAWFORD DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "KYIAH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "240-839-5100",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FENTON FAMILY DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.