Crystal Grace Watson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

8221 Issued in NC

Practice address

2620 New Bern Avenue
New Bern Ridge Dental Center
Raleigh, NC 27610

Phone

(919) 250-2930

Fax

(919) 231-8077

NPI assigned

Nov 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ms. Crystal Grace McCleary Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1609948439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2168 PERSIMMON RIDGE DRIVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27604",
            "telephone_number": "919-760-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 NEW BERN AVENUE",
            "address_2": "NEW BERN RIDGE DENTAL CENTER",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27610",
            "telephone_number": "919-250-2930",
            "fax_number": "919-231-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "CRYSTAL",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "8221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904004",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "9027F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "MCCLEARY",
            "middle_name": "GRACE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tociana Watley, LCSWA
• Watson Dry Eye Center, PA
• Chanielle Watson
• Christina Watson
• Christina Mary Watson, P.T.
• Derek Philip Watson, MD
• Dominique Watson
• Eloise B. Watson, M.D.
• Hannah Catherine Watson
• Hayley Watson

• Dentist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.