NPIMap

Organization Active NPI

Paolo a Poidmore and Brian C Crawford Dental Corporation

  • General Practice Dentistry
  • Antelope, CA
National Provider Identifier
1871315259
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PAOLO A POIDMORE AND BRIAN C CRAWFORD DENTAL CORPORATION
Practice address
4408 Elverta Rd Ste 200
Antelope, CA 95843-6723
Phone
(916) 259-9255
Fax
(916) 384-3844
NPI assigned
Oct 28, 2024
Organization subpart
Yes
Parent organization
PAOLO A POIDMORE AND BRIAN C CRAWFORD DENTAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Dr. Brian Crawford, DDS
Title
Owner
Phone
(916) 259-9255

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

4408 Elverta Rd Ste 200
Antelope, CA 95843-6723

Mailing address

3075 Beacon Blvd
West Sacramento, CA 95691-3462
Phone (916) 259-9255

Other names 1

  • Cali Kids Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Paolo a Poidmore and Brian C Crawford Dental Corporation4 organizations share this tax ID, including this one
Part of
Paolo a Poidmore and Brian C Crawford Dental Corporation

Other organizations with this tax ID 3

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1871315259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 BEACON BLVD",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913462",
            "telephone_number": "916-259-9255",
            "fax_number": "916-384-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4408 ELVERTA RD STE 200",
            "city": "ANTELOPE",
            "state": "CA",
            "postal_code": "958436723",
            "telephone_number": "916-259-9255",
            "fax_number": "916-384-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAOLO A POIDMORE AND BRIAN C CRAWFORD DENTAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAOLO A POIDMORE AND BRIAN C CRAWFORD DENTAL CORPORATION",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-259-9255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cali Kids Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Antelope, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.