Individual provider Active NPI

Phillip C Crawford, DDS

  • Public Health Dentistry
  • Pahokee, FL
National Provider Identifier
1851311963
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
DN6324 Issued in FL
Practice address
1200 E Main St
Pahokee, FL 33476-1102
Phone
(561) 924-0184
Fax
(561) 924-2516
NPI assigned
Jul 20, 2006
Last updated
Feb 20, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X DN6324 FL Primary

Addresses

Primary practice location

1200 E Main St
Pahokee, FL 33476-1102

Mailing address

4824 Brandywine Dr
Boca Raton, FL 33487-2108
Phone (561) 994-0047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160729000265 FL Order and Referring Only - DentistPractitioner - Dentist 8224321153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1851311963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 BRANDYWINE DR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334872108",
            "telephone_number": "561-994-0047",
            "fax_number": "561-994-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MAIN ST",
            "city": "PAHOKEE",
            "state": "FL",
            "postal_code": "334761102",
            "telephone_number": "561-924-0184",
            "fax_number": "561-924-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "PHILLIP",
        "middle_name": "C",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "FL",
            "license": "DN6324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pahokee, FL

Sources for this page

Verify at the official NPI Registry.