DENNIS M CROCKETT (NPI# 1356362800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356362800 |
| Entity Type | Individual |
| Full Name | DENNIS M CROCKETT |
| Credential | MD |
| Practice Address |
26726 Crown Valley Pkwy. Suite 200 Head & Neck Associates of Orange County Mission Viejo CA 92691 |
| Practice Telephone | 9493644361 |
| Practice Fax Number | 9493644495 |
| Mailing Telephone | 9493644361 |
| Mailing Fax Number | 9493644495 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2008-11-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
G42104 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GEL PTAN | W8109 | 01 | |
| CA | 00G421040 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851490767 | Dennis G Crockett | Anesthesiology | 2175 Rosaline Ave, Redding, CA 96001 | 2006-09-21 |
| Street Address |
26726 CROWN VALLEY PKWY. SUITE 200 HEAD & NECK ASSOCIATES OF ORANGE COUNTY |
| City | MISSION VIEJO |
| State | CA |
| Zip Code | 92691 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134748247 | Sonja Wood | Registered Nurse | 92691 Avenida Deseo, Mission Viejo, CA 92691 | 2020-04-09 |
| 1912488487 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 27551 Puerta Real, Mission Viejo, CA 92691 | 2018-08-23 |
| 1518457704 | Leon Baginski Md Inc | Obstetrics & Gynecology | 26800 Crown Valley Pkwy Ste 560, Mission Viejo, CA 92691 | 2018-05-14 |
| 1215426762 | Gail G Warner | Marriage & Family Therapist | 26050 Acero, Suite 301, Mission Viejo, CA 92691 | 2018-05-09 |
| 1508354176 | Tania Choudhary | Student in an Organized Health Care Education/Training Program | 23595 Rangoon St, Mission Viejo, CA 92691 | 2018-04-28 |
| 1710486519 | Aubriana Denise Gray | Counselor | 25802 Pacifica Ave, Mission Viejo, CA 92691 | 2018-02-07 |
| 1487162707 | Alberto Israel Galicia | Case Manager/Care Coordinator | 27261 Las Ramblas, Suite 220, Mission Viejo, CA 92691 | 2018-01-22 |
| 1629595244 | Elisabeth A Lischer | Counselor | 26137 La Paz Road, Suite 230, Mission Viejo, CA 92691 | 2017-08-24 |
| 1639694227 | Dr. Horiyat, A Dental Corporation | Dentist | 27652 Crown Valley Parkway, Mission Viejo, CA 92691 | 2017-08-04 |
| 1255851689 | Jackelin Liseth Martinez | Counselor | 25402 Pacifica Avenue, Mission Viejo, CA 92691 | 2017-06-27 |
| Find all providers in zip 92691 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053321000 | James A. Heinrich | Otolaryngology | 26730 Crown Valley Pkwy Ste 250, Mission Viejo, CA 92691-8000 | 2006-08-09 |
| 1386954030 | James A. Heinrich, M.d., Inc. | Otolaryngology | 26730 Crown Valley Pkwy Ste 250, Mission Viejo, CA 92691-8000 | 2010-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770041881 | Robotic Brain and Spine Institute Inc | Otolaryngology | 9201 W Sunset Blvd Ste 405, Los Angeles, CA 90069-3705 | 2019-03-07 |
| 1447500269 | Esrafil Abedi Md A Professional Corporation | Otolaryngology | 23961 Calle Magdalena St, 430, Laguna Hills, CA 92653-3685 | 2012-09-19 |
| 1184971194 | Gabriel Gabarain | Otolaryngology | 4646 Brockton Ave Ste 201, Riverside, CA 92506 | 2012-08-08 |
| 1154636769 | Louis G. Brennan | Otolaryngology | 4 Leicester Ct, Laguna Niguel, CA 92677-9380 | 2010-08-09 |
| 1568783470 | Dana Kristopher Petersen | Otolaryngology | 1001 Potrero St, San Francisco General Hospital, San Francisco, CA 94110 | 2010-06-15 |
| 1275784233 | Stephen Wayne Hargett | Otolaryngology | 1200 North State St., Los Angeles, CA 90033 | 2008-10-08 |
| 1568664548 | Geoffrey Arthur Smith | Otolaryngology | 7910 Frost St # 420, San Diego, CA 92123-2771 | 2007-06-03 |
| 1831319326 | Shamit Chopra | Otolaryngology | 2521 Stockton Blvd Ste 7200, Sacramento, CA 95817-2207 | 2007-04-26 |
| 1194941641 | Ronaldo A Ballecer | Otolaryngology | 540 E Herndon Ave Ste 105, Suite 105, Fresno, CA 93720-2993 | 2007-04-17 |
| 1669515862 | Kaniff Cosmetic Medical Center, Inc | Otolaryngology | 631 Fulton Ave, Sacramento, CA 95825-4813 | 2007-02-15 |
| Find all providers with the same taxonomy | ||||
| City | MISSION VIEJO |
| Zip Code | 92691 |
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| 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.