Ronald K. Creecy, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DSO28378L Issued in PA

Practice address

5058 City Line Ave
Philadelphia, PA 19131-1441

Phone

(856) 345-8039

NPI assigned

Dec 14, 2010

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

Other names 1

• Dr. Ronald K. Creecy Professional name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343347200000",
    "number": "1639472608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 STANLEY AVE",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080571849",
            "telephone_number": "856-345-8039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5058 CITY LINE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311441",
            "telephone_number": "856-345-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREECY",
        "first_name": "RONALD",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-14",
        "last_updated": "2012-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DSO28378L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6361404",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RONALD",
            "last_name": "CREECY",
            "middle_name": "K.",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Creative Process Therapy LLC (RBraun Art & Therapy)
• Creative Steps Incorporated
• Anthony Creato, PA-C
• Credence Home Care Agency, Inc (Credence Eldercare Services)
• Credo Trans, Inc
• Creighton Charter School
• Christine Creighton
• Creme de la Creme Home Health Care LLC
• Charles Crepy D'Orleans
• Crescent Care LLC (Affinity Home Care Services)

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.