Individual provider Active NPI

Craig R Rainer, DDS

  • General Practice Dentistry
  • Fredericksburg, VA
National Provider Identifier
1912259631
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28458 Issued in TX
Practice address
3533 Plank Rd
Fredericksburg, VA 22407-6830
Phone
(540) 306-5595
NPI assigned
Oct 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401418135 VA
General Practice Dentistry 1223G0001X 28458 TX Primary

Addresses

Primary practice location

3533 Plank Rd
Fredericksburg, VA 22407-6830

Mailing address

2613 Glenriver Way
Woodbridge, VA 22191-5178
Phone (571) 237-7982

Other practice location 1

6065 Montana Ave
El Paso, TX 79925-1835
Phone (915) 613-5846

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
0401418135VAMDGeneral Practice Dentistry
28458TXMDGeriatric Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1912259631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2613 GLENRIVER WAY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221915178",
            "telephone_number": "571-237-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 PLANK RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076830",
            "telephone_number": "540-306-5595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6065 Montana Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799251835",
            "country_code": "US",
            "telephone_number": "915-613-5846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAINER",
        "first_name": "CRAIG",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-04",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418135",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.