Active NPI
Robert Peter Crannage III, DDS
- General Practice Dentistry
- Albuquerque, NM
National Provider Identifier
1801779665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DB-2025-0143
- Practice address
- 2800 Coors Blvd NW Ste a
Albuquerque, NM 87120-1204 - Phone
- (505) 352-1166
- Fax
- (505) 352-2805
- NPI assigned
- Jul 29, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DB-2025-0143 | NM | Primary |
Addresses
Primary practice location
2800 Coors Blvd NW Ste a
Albuquerque, NM 87120-1204
Mailing address
2800 Coors Blvd NW Ste a
Albuquerque, NM 87120-1204
Phone (505) 352-1166
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
| License | State | Type | Specialty |
|---|---|---|---|
| DB-2025-0143 | NM | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CRDS | Past | Accepting new patients | |
| Albuquerque Modern Dentistry, LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Albuquerque, NM
- NPI 1487953790
General Practice
-
- Dentist
- Albuquerque, NM
- NPI 1013390087
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753747200000",
"number": "1801779665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 COORS BLVD NW STE A",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871201204",
"telephone_number": "505-352-1166",
"fax_number": "505-352-2805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 COORS BLVD NW STE A",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871201204",
"telephone_number": "505-352-1166",
"fax_number": "505-352-2805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANNAGE",
"first_name": "ROBERT",
"middle_name": "PETER",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-07-29",
"last_updated": "2025-07-29",
"certification_date": "2025-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NM",
"license": "DB-2025-0143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.