Derrick Myron Crawford, DDS, MS
Dentist, Orthodontics and Dentofacial Orthopedics in Moscow, ID. Individual provider (NPI-1).
NPI number1497323976
StatusActive
Last updated in NPPESJun 11, 2021
Details
- NPI
- 1497323976
- Entity type
- Individual (NPI-1)
- Name
- Derrick Myron Crawford
- Credential
- DDS, MS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 11, 2021
- Certification date
- Jun 11, 2021
- Last updated
- Jun 11, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | D-5265 | ID | Yes |
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | DE61157527 | WA |
Practice location
505 S Mountain View RdMoscow, ID 83843-9205
Phone 208-882-6360
Mailing address
1005 Sw Latour Peak StPullman, WA 99163-5287
Phone 626-260-0729
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.