Individual provider Active NPI

Donald A. Crumb, DDS

  • General Practice Dentistry
  • Syracuse, NY
National Provider Identifier
1689703340
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
031300 Issued in NY
Practice address
1000 E Genesee St
Suite 501
Syracuse, NY 13210-1892
Phone
(315) 475-6641
Fax
(315) 475-6651
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 031300 NY Primary

Addresses

Primary practice location

1000 E Genesee St
Suite 501
Syracuse, NY 13210-1892

Mailing address

1000 E Genesee St
Suite 501
Syracuse, NY 13210-1892
Phone (315) 475-6641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140918000128 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9335368679

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
031300NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Dental Concepts of Cny PLLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689703340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E GENESEE ST",
            "address_2": "SUITE 501",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101892",
            "telephone_number": "315-475-6641",
            "fax_number": "315-475-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E GENESEE ST",
            "address_2": "SUITE 501",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101892",
            "telephone_number": "315-475-6641",
            "fax_number": "315-475-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMB",
        "first_name": "DONALD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "031300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.