Active NPI
Marie Crocker, DDS
- General Practice Dentistry
- Cambridge Springs, PA
National Provider Identifier
1619988037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS028556L
- Practice address
- 750 Venango Ave
Cambridge Springs, PA 16403 - Phone
- (814) 398-2656
- Fax
- (814) 398-1438
- NPI assigned
- Aug 10, 2006
- Last updated
- Jan 18, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS028556L | PA | Primary |
Addresses
Primary practice location
750 Venango Ave
Cambridge Springs, PA 16403
Mailing address
750 Venango Ave
Cambridge Springs, PA 16403
Phone (814) 398-2656
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001657950001 | Other | PA | DEPT OF PUBLIC AID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS028556L | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spa Dental Center | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326844800000",
"number": "1619988037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 VENANGO AVE",
"city": "CAMBRIDGE SPRINGS",
"state": "PA",
"postal_code": "16403",
"telephone_number": "814-398-2656",
"fax_number": "814-398-1438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 VENANGO AVE",
"city": "CAMBRIDGE SPRINGS",
"state": "PA",
"postal_code": "16403",
"telephone_number": "814-398-2656",
"fax_number": "814-398-1438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROCKER",
"first_name": "MARIE",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-10",
"last_updated": "2012-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS028556L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF PUBLIC AID",
"identifier": "001657950001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cambridge Springs, PA
- Cherish H Church, D.O.
- Conneaut Valley Health Center Inc. (Cambridge Springs Health Center)
- Wendi Connelly, RD, LDN
- Counseling Corner LLC
- Salene J Cowher, PH.D.
- Bridget Dolnosich, PT
- Ggnsc Cambridge Springs LP (Golden LivingCenter - Cambridge Springs)
- Samuel Edward Glossner, LPC, CAADC, CRS
- Angel F Gressel, CRNP, PMHNP-BC
- Elizabeth A Henry Burnett, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.