Mikai J Critchfield, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10967 Issued in KY

Practice address

640 Ervay Ave
Louisville, KY 40217-1928

Phone

(919) 903-6549

NPI assigned

May 16, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1699466268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 ERVAY AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171928",
            "telephone_number": "919-903-6549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ERVAY AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171928",
            "telephone_number": "919-903-6549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRITCHFIELD",
        "first_name": "MIKAI",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Crisp, RBT
• Seaton Brady Crisp, PA-C
• Dana Cristina, M.ED. LPCC
• Mickenzie Jo Criswell, PTA
• Agatha S Critchfield, MD
• Jennifer Croasdaile, LCSW
• Kimberly Crocetti, PT
• Tanya Ezell Crockett, APRN, CPNP-PC
• Andrew Croft, MD
• Cara D Croft

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.