Crystal Isenhower, DMD, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

3529 Issued in SC

Legal business name

CRYSTAL ISENHOWER, DMD, LLC

Practice address

107 Waccamaw Medical Park Dr
Conway, SC 29526-8902

Phone

(843) 234-3110

Fax

(843) 234-3109

NPI assigned

Aug 21, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Crystal Rae Isenhower, DMD

Title

Dentist

Phone

(843) 234-3110

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Crystal H Isenhower, DMD

  • General Practice Dentistry
  • Conway, SC
  • NPI 1336326727
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629184171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WACCAMAW MEDICAL PARK DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268902",
            "telephone_number": "843-234-3110",
            "fax_number": "843-234-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WACCAMAW MEDICAL PARK DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268902",
            "telephone_number": "843-234-3110",
            "fax_number": "843-234-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL ISENHOWER, DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ISENHOWER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "843-234-3110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "3529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA967S",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seleah Lavette Crosland, M.A, LPC,NCC
• Stacey L Crowder, M.ED., CCC-SLP
• Kaitlin Crutcher
• James Robles Cruz, P.T.A.
• Joanne Cruzado, RN, BSN
• Delana Rae Cudd, RPH
• Michelle Lee Cudd, RN
• Evan Samuel Culp, CRNA
• Leonard Brown Cummings IX
• Dana L. Dagostino

• Dentist in Conway, SC
• Providers in Conway, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.