Individual provider Active NPI

Todd M. Crandall, D.D.S.

  • General Practice Dentistry
  • Centennial, CO
National Provider Identifier
1831541879
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN.00202873 Issued in CO
Practice address
15250 E Orchard Rd
Centennial, CO 80016-3003
Phone
(303) 680-9990
Fax
(303) 699-6244
NPI assigned
Jul 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DEN.00202873 CO Primary

Addresses

Primary practice location

15250 E Orchard Rd
Centennial, CO 80016-3003

Mailing address

16911 E Dorado Dr
Centennial, CO 80015-3027
Phone (303) 570-2766

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
DEN.00202873COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mack Family Dental PC PastSince Sep 1, 2021 Accepting new patients
Comfort Dental Parker Road 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.

NPI Registry JSON

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

{
    "created_epoch": "1467331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1831541879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16911 E DORADO DR",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800153027",
            "telephone_number": "303-570-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15250 E ORCHARD RD",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800163003",
            "telephone_number": "303-680-9990",
            "fax_number": "303-699-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "TODD",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-01",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00202873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; 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.