NPIMap

Organization Active NPI

Dr. Paula S. Crum, S.C.

  • Periodontics
  • Green Bay, WI
National Provider Identifier
1710018882
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
3119 Issued in WI
Legal business name
DR. PAULA S. CRUM, S.C.
Practice address
2581 Development Dr
Suite 204
Green Bay, WI 54311-4247
Phone
(920) 347-2640
Fax
(920) 347-2641
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Paula S. Crum, D.D.S., M.S.NPI 1790816874
Title
President
Phone
(920) 347-2640

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 3119 WI Primary

Addresses

Primary practice location

2581 Development Dr
Suite 204
Green Bay, WI 54311-4247

Mailing address

2581 Development Dr
Suite 204
Green Bay, WI 54311-4247
Phone (920) 347-2640

National Provider Directory

National Provider Directory

Locations

2581 Development Dr
Ste 204
Green Bay, WI 54311
Phone (920) 347-2640

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710018882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2581 DEVELOPMENT DR",
            "address_2": "SUITE 204",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114247",
            "telephone_number": "920-347-2640",
            "fax_number": "920-347-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2581 DEVELOPMENT DR",
            "address_2": "SUITE 204",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114247",
            "telephone_number": "920-347-2640",
            "fax_number": "920-347-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. PAULA S. CRUM, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CRUM",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-347-2640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "WI",
            "license": "3119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • 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.