Ronald John Croteau, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2183 Issued in WV

Practice address

1207 Morgantown Avenue
Fairmont, WV 26554-4503

Phone

(304) 366-7002

Fax

(304) 366-7020

NPI assigned

Nov 2, 2006

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 1

Addresses

Other identifiers 1

Other names 1

• Ronald J Croteau Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750469011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 MORGANTOWN AVENUE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265544503",
            "telephone_number": "304-366-7002",
            "fax_number": "304-366-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 MORGANTOWN AVENUE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265544503",
            "telephone_number": "304-366-7002",
            "fax_number": "304-366-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROTEAU",
        "first_name": "RONALD",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "2183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0134953000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RONALD",
            "last_name": "CROTEAU",
            "middle_name": "J",
            "credential": "PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dentist in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Dentist in West Virginia

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.