Organization Active NPI

Crawford Orthodontic Care, P.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Norcross, GA
National Provider Identifier
1861610081
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN009310 Issued in GA
Legal business name
CRAWFORD ORTHODONTIC CARE, P.C.
Practice address
3850 Holcomb Bridge Rd
Suite 230
Norcross, GA 30092-5223
Phone
(770) 447-5311
Fax
(770) 447-1865
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Keith Scott Crawford
Title
Owner
Phone
(770) 447-5311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X DN009310 GA Primary

Addresses

Primary practice location

3850 Holcomb Bridge Rd
Suite 230
Norcross, GA 30092-5223

Mailing address

3850 Holcomb Bridge Rd
Suite 230
Norcross, GA 30092-5223
Phone (770) 447-5311

Other identifiers 1

IdentifierTypeStateIssuer
00217797BMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Crawford Orthodontic Care4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3850 Holcomb Bridge Rd
Ste 230
Norcross, GA 30092
Phone (404) 846-7603

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861610081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 HOLCOMB BRIDGE RD",
            "address_2": "SUITE 230",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300925223",
            "telephone_number": "770-447-5311",
            "fax_number": "770-447-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 HOLCOMB BRIDGE RD",
            "address_2": "SUITE 230",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300925223",
            "telephone_number": "770-447-5311",
            "fax_number": "770-447-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAWFORD ORTHODONTIC CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-447-5311",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN009310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00217797B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.