Individual provider Active NPI

Emily Suzanne McCrea, D.D.S.

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1770837205
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011638A Issued in IN
Practice address
450 E Ohio St
Apt 105
Indianapolis, IN 46204-2680
Phone
(260) 414-4583
NPI assigned
Nov 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12011638A IN Primary

Addresses

Primary practice location

450 E Ohio St
Apt 105
Indianapolis, IN 46204-2680

Mailing address

450 E Ohio St
Apt 105
Indianapolis, IN 46204-2680
Phone (260) 414-4583

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
12011638AINMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1770837205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E OHIO ST",
            "address_2": "APT 105",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462042680",
            "telephone_number": "260-414-4583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E OHIO ST",
            "address_2": "APT 105",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462042680",
            "telephone_number": "260-414-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCREA",
        "first_name": "EMILY",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-06",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011638A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.