DR. PHILLIP CRUM (NPI# 1235683830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1235683830 |
Entity Type | Individual |
Full Name | DR. PHILLIP CRUM |
Credential | D.D.S. |
Practice Address |
2581 Development Dr Ste 204 Bellevue WI 54311-4248 |
Practice Telephone | 9203472640 |
Mailing Telephone | 9203472640 |
Enumeration Date | 2016-08-11 |
Last Update Date | 2020-01-07 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0300X |
Dentist Specialization: Periodontics |
1002021-15 | WI | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457995276 | Phillip Crum | Peer Specialist | 201 Mechanic St, Lexington, KY 40507-1086 | 2019-11-05 |
Street Address |
2581 DEVELOPMENT DR STE 204 |
City | BELLEVUE |
State | WI |
Zip Code | 54311-4248 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295333847 | Karen Ginnow | Pharmacist | Walmart #1908, 2292 Main St, Green Bay, WI 54311 | 2020-10-15 |
1639786551 | Maggie Hall | Dental Hygienist | 2633 Development Dr. Ste 40, Green Bay, WI 54311 | 2020-09-24 |
1295370807 | Jennifer Marie Arendt | Technician | 2970 Mossy Oak Cir #39, Green Bay, WI 54311 | 2019-11-07 |
1518508803 | Cheryl Ann Johnson | Specialist | 830 Edgewood Dr., Green Bay, WI 54311 | 2019-10-08 |
1124670898 | Robert H Wagner Family Dentist S.c. | Dentist | 2830 Curry Court, Suite 1, Green Bay, WI 54311 | 2019-07-12 |
1821659624 | The Salvation Army | Counselor | The Salvation Army Ray & Joan Kroc Center, 1315 Lime Kiln Road, Green Bay, WI 54311 | 2019-06-24 |
1578052866 | Matthew Robert Wagner | Dentist | 2830 Curry Ln #1, Green Bay, WI 54311 | 2018-05-02 |
1861916769 | Atlas Spinal Care | Chiropractor | 2069 Central Ct, Suite 11, Green Bay, WI 54311 | 2017-08-01 |
1851844161 | Green Bay Family Dental LLC | Dentist | 2609 Development Dr., Green Bay, WI 54311 | 2016-08-03 |
1710382809 | Betsy Hoida | Pharmacist | 2485 Greenbrier Rd., Green Bay, WI 54311 | 2014-10-31 |
Find all providers in zip 54311 |
Taxonomy Code | 1223P0300X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Periodontics |
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225445539 | Implant & Periodontic Specialists | Dentist | 1418 112th Ave Ne Suite 100, Bellevue, WA 98004 | 2014-07-18 |
1639416183 | Jessica R Swoboda | Dentist | 10050 Ne 10th St # Stc, Bellevue, WA 98004-4121 | 2013-01-03 |
1508102120 | Premier Periodontics Pplc | Dentist | 10050 Ne 10th St Suite C, Bellevue, WA 98004 | 2012-12-31 |
1861791915 | Rosemary Thomas | Dentist | 14655 Ne Bel Red Rd Ste 202, Bellevue, WA 98007-3900 | 2011-03-15 |
1114049574 | Huda Albather | Dentist | 14700 Ne 8th St Ste 205, Bellevue, WA 98007-4115 | 2007-04-05 |
1750402285 | Cheryl L Townsend | Dentist | 14420 Bel Red Rd Ste 101, Bellevue, WA 98007-3930 | 2007-04-02 |
1912053836 | Toyo Matsumoto | Dentist | 3316 129th Ave Ne, Bellevue, WA 98005-1347 | 2007-01-25 |
1346328523 | Erika Smith Macdonald | Dentist | 121 112th Ave Ne, Suite A, Bellevue, WA 98004 | 2006-11-02 |
1821625989 | Rosemary Thomas, Pllc | Dentist | 14655 Ne Bel Red Rd Ste 202, Bellevue, WA 98007-3900 | 2020-03-26 |
1962933150 | Edward Im Dds Ps | Dentist | 1200 112th Ave Ne, C222, Bellevue, WA 98004-3732 | 2017-03-21 |
Find all providers in BELLEVUE |
Please comment or provide details below to improve the information on DR. PHILLIP CRUM.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.