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CRESCENT DENTAL GROUP PLLC NPI 1578024774


NPI Information

NPI: 1578024774
Provider Name: CRESCENT DENTAL GROUP PLLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 37D2201524

Address:
120 N GRAND
CRESCENT, OK
ZIP 73028
Phone: (405) 969-3969
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CRESCENT DENTAL GROUP PLLC is a general practice dentist in Crescent, OK. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. CRESCENT DENTAL GROUP PLLC NPI is 1578024774. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

120 N GRAND
CRESCENT, OK
ZIP 73028
Phone: (405) 969-3969

The provider's authorized official is Joshua Brasher .
The authorized official title is President and has the following contact phone number (405) 474-6362.

The CLIA number assigned to this NPI record is 37D2201524 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/29/2019 and was last updated on 12/12/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.