NPIMap

Organization Active NPI

Roslyn M. Crisp DD, Ms, PA

  • Dentist
  • Burlington, NC
National Provider Identifier
1881985398
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
200001988472 Issued in NC
Legal business name
ROSLYN M. CRISP DD, MS, PA
Practice address
1203 Vaughn Rd
Burlington, NC 27217-2846
Phone
(336) 228-8392
Fax
(336) 227-0635
NPI assigned
May 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Authorized official

Name
Mr. Pete Moore
Title
Business Office Manager
Phone
(336) 524-5439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 200001988472 NC Primary

Addresses

Primary practice location

1203 Vaughn Rd
Burlington, NC 27217-2846

Mailing address

1203 Vaughn Rd
Burlington, NC 27217-2846
Phone (336) 228-8392

National Provider Directory

National Provider Directory
Tax ID family
Dr Roslyn M Crisp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1881985398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 VAUGHN RD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272172846",
            "telephone_number": "336-228-8392",
            "fax_number": "336-227-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 VAUGHN RD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272172846",
            "telephone_number": "336-228-8392",
            "fax_number": "336-227-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSLYN M. CRISP DD, MS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-02",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "PETE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "336-524-5439",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "200001988472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.