W Dale Crum, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

7006 Issued in WA

Practice address

2204 E 29TH Ave
Ste 104
Spokane, WA 99203-3961

Phone

(509) 928-8800

Fax

(509) 321-0154

NPI assigned

Jun 13, 2005

Last updated

Apr 15, 2010By 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Inland Oral Surgery P.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Spokane, WA
  • NPI 1982965976
  NPD (past) Authorized official
• Oral Surgery Plus P.S.

  • Oral and Maxillofacial Pathology Dentistry
  • Spokane, WA
  • NPI 1942410436
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1609870070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 E 29TH AVE",
            "address_2": "STE 104",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992033961",
            "telephone_number": "509-928-8800",
            "fax_number": "509-321-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 E 29TH AVE",
            "address_2": "STE 104",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992033961",
            "telephone_number": "509-928-8800",
            "fax_number": "509-321-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUM",
        "first_name": "W DALE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "7006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5026117",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Marissa Croy, PHARMD
• Sara Elizabeth Croy, RN
• Camila Fernanda Cruces Ramirez
• Irene Cruite, M.D.
• Timothy E Crum, MD
• David R Crump
• Robert G Crump
• Steven G Crump, D.D.S.
• Katrina Amanda Marie Cruz Avila
• Felicia K Cruz Heinz, LMP

• Oral and Maxillofacial Surgery (Dentist) in Spokane, WA
• Providers in Spokane, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.