Craig Douglas Crispin, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28530 Issued in CA

Practice address

60 Fourth St.
Suite B
Point Reyes Station, CA 94956-0550

Phone

(415) 663-1430

NPI assigned

Jan 22, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578617452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "address_2": "60 FOURTH ST. SUITE B",
            "city": "POINT REYES STATION",
            "state": "CA",
            "postal_code": "949560550",
            "telephone_number": "415-663-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 FOURTH ST.",
            "address_2": "SUITE B",
            "city": "POINT REYES STATION",
            "state": "CA",
            "postal_code": "949560550",
            "telephone_number": "415-663-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISPIN",
        "first_name": "CRAIG",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "28530",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "94-2908493",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Health Alliance (Point Reyes Medical Clinic)
• Coastal Health Alliance (Point Reyes Medical Clinic)
• Coastal Health Alliance
• Colin Hamblin, a Professional Medical Corporation
• County of Marin
• Kathie Marie Dalessandri, M.D.
• Robyn Gay El-Bardai, MA
• Martha Jean Frankel, R.N., F.N.P., M.F.C.
• James Kimball Goetz, PSY. D.
• Basil Colin Hamblin, MD

• General Practice Dentistry in Point Reyes Station, CA
• Providers in Point Reyes Station, CA by specialty
• General Practice Dentistry in California

• 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.