Individual provider Active NPI

Bill Clay Crafton, D.D.S.

  • General Practice Dentistry
  • Chula Vista, CA
National Provider Identifier
1679654362
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22057 Issued in CA
Practice address
257 F St
Chula Vista, CA 91910-2821
Phone
(619) 425-2600
Fax
(619) 425-6636
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22057 CA Primary

Addresses

Primary practice location

257 F St
Chula Vista, CA 91910-2821

Mailing address

257 F St
Chula Vista, CA 91910-2821
Phone (619) 425-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20150625001666 CA Order and Referring Only - DentistPractitioner - Dentist 6204147630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22057CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1679654362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 F ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102821",
            "telephone_number": "619-425-2600",
            "fax_number": "619-425-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 F ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102821",
            "telephone_number": "619-425-2600",
            "fax_number": "619-425-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAFTON",
        "first_name": "BILL",
        "middle_name": "CLAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "22057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.