Crismon Road Dmso LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CRISMON ROAD DMSO LLC

Practice address

1157 S Crismon Rd Ste 103
Mesa, AZ 85208-2661

Phone

(480) 393-0687

NPI assigned

Aug 3, 2017

Organization subpart

No

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

Authorized official

Name

Tracy H Tran, MBA/MPH

Title

Manager

Phone

(408) 234-5099

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Gerard Garcia, DDS

  • General Practice Dentistry
  • Mesa, AZ
  • NPI 1336350529
  NPD (past)

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1851815575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 S CRISMON RD STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852082661",
            "telephone_number": "480-393-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 S CRISMON RD STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852082661",
            "telephone_number": "480-393-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISMON ROAD DMSO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "408-234-5099",
        "authorized_official_credential": "MBA/MPH"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crexmed
• Jared Matthew Criddle, M.D.
• Allen J Crimmins
• Natalie Sabrina Crisan, DO
• Crismon Peaks Assisted Living, LLC
• Cali Crismon, LAC
• Michael D Crismon, D.C.
• Michael Crockett, DDS
• Christa Crohurst, LAC
• Chyann Croley, DPT

• Dental Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.