Active NPI
Josh Crank, D.M.D.
- General Practice Dentistry
- Eagle, ID
National Provider Identifier
1992188353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D-4665
- Practice address
- 386 Longwood Dr
Eagle, ID 83616-5188 - Phone
- (480) 293-4196
- NPI assigned
- Jul 2, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D-4665 | ID | Primary |
Addresses
Primary practice location
386 Longwood Dr
Eagle, ID 83616-5188
Mailing address
1311 E Central Dr
Meridian, ID 83642-7991
Phone (480) 293-4196
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160523001266 | ID | Order and Referring Only - Dentist | 7911296454 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-4665 | ID | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435795200000",
"number": "1992188353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 E CENTRAL DR",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836427991",
"telephone_number": "480-293-4196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "386 LONGWOOD DR",
"city": "EAGLE",
"state": "ID",
"postal_code": "836165188",
"telephone_number": "480-293-4196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANK",
"first_name": "JOSH",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-02",
"last_updated": "2015-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D-4665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagle, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.