Individual provider Active NPI

Hunter James Crockett, DMD

  • Dentist
  • Keene, NH
National Provider Identifier
1861182602
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
05149 Issued in NH
Practice address
19 Elm St # 2
Keene, NH 03431-3475
Phone
(603) 352-0321
NPI assigned
May 12, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN5040 ME
Dentist 122300000X 05149 NH Primary

Addresses

Primary practice location

19 Elm St # 2
Keene, NH 03431-3475

Mailing address

52 Brunswick Ave
Fort Fairfield, ME 04742-1110
Phone (508) 579-7513

Other practice location 1

1 North St
Presque Isle, ME 04769-2240
Phone (207) 760-7216

Other practice location 2

206 Main St
Fort Fairfield, ME 04742-1121
Phone (207) 473-7723

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
DEN5040MEMDDentist
05149NHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
White Smiles Family Dentistry PastSince May 1, 2023 Accepting new patients
White Smiles Family Dentistry Past Accepting new patients
White Smiles Family Dentistry Dentist PastSince May 1, 2023 Accepting new patients

Organizations & group practices 3

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": "1683849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1861182602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 BRUNSWICK AVE",
            "city": "FORT FAIRFIELD",
            "state": "ME",
            "postal_code": "047421110",
            "telephone_number": "508-579-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 ELM ST # 2",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313475",
            "telephone_number": "603-352-0321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 North St",
            "address_purpose": "LOCATION",
            "city": "Presque Isle",
            "state": "ME",
            "postal_code": "047692240",
            "country_code": "US",
            "telephone_number": "207-760-7216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Fairfield",
            "state": "ME",
            "postal_code": "047421121",
            "country_code": "US",
            "telephone_number": "207-473-7723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "HUNTER",
        "middle_name": "JAMES",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-12",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "DEN5040",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "05149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.