Individual provider Active NPI

Crystal Camden, DMD

  • Dentist
  • Bradenton, FL
National Provider Identifier
1710430988
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN22002 Issued in FL
Practice address
5205 Office Park Blvd
Bradenton, FL 34203
Phone
(941) 725-1128
NPI assigned
Jul 25, 2016
Last updated
Apr 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN22002 FL Primary

Addresses

Primary practice location

5205 Office Park Blvd
Bradenton, FL 34203

Mailing address

5205 Office Park Blvd
Bradenton, FL 34203
Phone (941) 725-1128

Other practice location 1

3030 US Highway 301 N
Ellenton, FL 34222-2010
Phone (941) 722-0502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN22002FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1710430988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 OFFICE PARK BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34203",
            "telephone_number": "941-725-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 OFFICE PARK BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34203",
            "telephone_number": "941-725-1128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 US Highway 301 N",
            "address_purpose": "LOCATION",
            "city": "Ellenton",
            "state": "FL",
            "postal_code": "342222010",
            "country_code": "US",
            "telephone_number": "941-722-0502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMDEN",
        "first_name": "CRYSTAL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN22002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; 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.