Brian Robert Crawford, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3734 Issued in ID

Practice address

465 Memorial Dr.
Pocatello, ID 83209-8088

Phone

(208) 282-5275

Fax

(208) 282-4950

NPI assigned

Apr 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Idaho State University

  dba Pocatello Family Dentistry

  • General Practice Dentistry
  • Pocatello, ID
  • NPI 1851516256
  NPD (past) Authorized official
• Idaho State University

  dba ISU Dental Hygiene Clinic

  • Dental Hygienist
  • Pocatello, ID
  • NPI 1972720936
  Authorized official Same address or phone

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730304437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 S. 8TH AVE., STOP 8088",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832098088",
            "telephone_number": "208-282-5275",
            "fax_number": "208-282-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MEMORIAL DR.",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832098088",
            "telephone_number": "208-282-5275",
            "fax_number": "208-282-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "BRIAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3734",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8068165",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gwen Cracroft
• Craft Pharmacy and Clinic, LLC
• Arminda Crane
• Todd Cranor, PA-C
• Trevor J. Crapo, LCSW
• Jonathan Cree, MD
• Creekside Hospice Inc.
• James E Creelman III, DPT
• Creighton Holdings PLLC (Ease-Breath.Feed.Thrive)
• Joshua Curtis Crosgrove

• General Practice Dentistry in Pocatello, ID
• Providers in Pocatello, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.