Individual provider Active NPI

William Edward Crofts, DDS

  • Dentist
  • Draper, UT
National Provider Identifier
1972717254
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D7567 Issued in OR
Practice address
12288 South 900 East
Draper, UT 84020
Phone
(801) 501-0209
Fax
(801) 501-7440
NPI assigned
May 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D7567 OR Primary

Addresses

Primary practice location

12288 South 900 East
Draper, UT 84020

Mailing address

1539 W Harvard Ave
Roseburg, OR 97470-2873
Phone (541) 673-5150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161102001316 ID Order and Referring Only - DentistPractitioner - Dentist 1254638364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D7567ORMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher S. Johnson, D.D.S., P.C. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1972717254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1539 W HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974702873",
            "telephone_number": "541-673-5150",
            "fax_number": "541-673-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12288 SOUTH 900 EAST",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "84020",
            "telephone_number": "801-501-0209",
            "fax_number": "801-501-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROFTS",
        "first_name": "WILLIAM",
        "middle_name": "EDWARD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D7567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

Verify at the official NPI Registry.