Individual provider Active NPI

Coulter Timothy Crowley, D.D.S.

  • General Practice Dentistry
  • Rancho Mirage, CA
National Provider Identifier
1992831705
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39249 Issued in CA
Practice address
61 Avenida Las Palmas
Rancho Mirage, CA 92270-4677
Phone
(760) 837-1983
Fax
(760) 346-9413
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 39249 CA Primary

Addresses

Primary practice location

61 Avenida Las Palmas
Rancho Mirage, CA 92270-4677

Mailing address

61 Avenida Las Palmas
Rancho Mirage, CA 92270-4677
Phone (760) 837-1983

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
39249CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992831705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 AVENIDA LAS PALMAS",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704677",
            "telephone_number": "760-837-1983",
            "fax_number": "760-346-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 AVENIDA LAS PALMAS",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704677",
            "telephone_number": "760-837-1983",
            "fax_number": "760-346-9413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWLEY",
        "first_name": "COULTER",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.