THANE EVANS CRUMP DDS PC (NPI# 1831391499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831391499 |
| Entity Type | Organization |
| Organization Name | THANE EVANS CRUMP DDS PC |
| Other Organization Name | LAKE AREA PEDIATRIC DENTISTRY |
| Practice Address |
600 4th St Ne Suite 208 Watertown SD 57201-1898 |
| Practice Telephone | 6057536824 |
| Mailing Telephone | 6057536824 |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. THANE CRUMP (DENTIST, OWNER) |
| Authorized Official Telephone | 6057536824 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 1223E0200X |
Dentist Specialization: Endodontics |
M 750 | SD | Dental Providers |
| X | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
M 750 | SD | Dental Providers |
| Other Name | Type Code |
|---|---|
| Lake Area Pediatric Dentistry | Other Name - Individual/Organization |
| Street Address |
600 4TH ST NE SUITE 208 |
| City | WATERTOWN |
| State | SD |
| Zip Code | 57201-1898 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821083841 | Melissa Marie Meester | Social Worker | 600 4th St Ne, Bridgeway Counseling Center Inc., Watertown, SD 57201 | 2005-09-15 |
| 1922459833 | Clayton Conroy | Dentist | 600 4th St Ne, Suite 207, Watertown, SD 57201-1898 | 2016-06-22 |
| 1851795884 | Lee Matthew Hendricks | Psychologist | 600 4th St Ne, Suite 203, Watertown, SD 57201-1898 | 2014-10-20 |
| 1326277625 | Bridgeway Counseling Center Inc. | Counselor | 600 4th St Ne, Suite 203, Watertown, SD 57201-1898 | 2009-07-08 |
| 1194903567 | Collin C. Palmquist Dds, PC | Dentist | 600 4th St Ne, Suite 201, Watertown, SD 57201-1898 | 2008-02-07 |
| 1710195896 | Thane Crump | Dentist | 600 4th St Ne, Suite 208, Watertown, SD 57201-1898 | 2007-05-20 |
| 1548480965 | Brian K Prouty Dds, PC | Dentist | 600 4th St Ne, Ste 102, Watertown, SD 57201-1898 | 2007-04-26 |
| 1447477930 | Arnold Orthodontics | Dentist | 600 4th St Ne, Suite 103, Watertown, SD 57201 | 2007-04-19 |
| 1467514984 | Brian K Prouty | Dentist | 600 4th St Ne, Ste102, Watertown, SD 57201-1898 | 2006-12-14 |
| 1932267911 | Michael Ashley Strom | Dentist | 600 4th St Ne, Watertown, SD 57201-1898 | 2006-12-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245878032 | Samantha Kay Kratovil | Dietitian, Registered | 4 19th St Ne, Watertown, SD 57201 | 2019-12-12 |
| 1326516501 | Edgewood Watertown Mc 2 LLC | Assisted Living Facility | 225 14 Ave Ne, Watertown, SD 57201 | 2018-11-06 |
| 1023503406 | Rhonda Jean Cyre | Occupational Therapy Assistant | 613 B 1st Ave Se, Watertown, SD 57201 | 2018-06-27 |
| 1083160717 | Joyce Anderson | Psychologist | 1124 Konrady Dr. Ne, Watertown, SD 57201 | 2016-09-01 |
| 1336584630 | Jeffrey Alan Dorrity | Otolaryngology | 1201 Mickelson Dr, Watertown, SD 57201 | 2013-05-01 |
| 1427397389 | Vickie Lynn Burchatz | Occupational Therapy Assistant | 415 Fourth Avenue Ne, Golden Living Center, Watertown, SD 57201 | 2013-02-12 |
| 1215292560 | Eagle Vision | Eyewear Supplier (Equipment, not the service) | 906 1/2 9th Ave Se, Watertown, SD 57201 | 2012-07-11 |
| 1669777462 | Eve Lynn Hensler | Audiologist | 405 18th Ave. Ne, Professional Hearing Services, Inc., Watertown, SD 57201 | 2011-01-26 |
| 1760792261 | Maria Redmond | Physical Therapist | 810 South Maple, Watertown, SD 57201 | 2010-10-18 |
| 1194918995 | Colette Wheeler | Occupational Therapist | 17330, 458th Ave, Watertown, SD 57201 | 2007-08-24 |
| Find all providers in zip 57201 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659987402 | Jeffrey Lawrence Levine | Dentist | 1340 Washington St, Watertown, NY 13601-4541 | 2020-09-17 |
| 1578926333 | Prairie Ridge Endodontics | Dentist | 600 4th St Ne Suite 101, Watertown, SD 57201 | 2016-03-30 |
| 1992010508 | Sarah Latif | Dentist | 1340 Washington St, Watertown, NY 13601-4541 | 2010-08-09 |
| 1811199250 | Dean Grinnell Hyde | Dentist | 128 Ten Eyck St, Watertown, NY 13601-3927 | 2007-06-05 |
| 1710195896 | Thane Crump | Dentist | 600 4th St Ne, Suite 208, Watertown, SD 57201-1898 | 2007-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427561042 | Michael Wheatley Dds of South Dakota PC | Dentist | 811 Belfast St, Yankton, SD 57078-3324 | 2017-11-06 |
| 1952509333 | Walter W Cox | Dentist | 708 S Roosevelt St, Aberdeen, SD 57401-0300 | 2007-07-06 |
| 1366596686 | Michael D. Homer | Dentist | 3500 S Kiwanis Ave, Suite 100, Sioux Falls, SD 57105-8119 | 2007-01-23 |
| 1841369816 | Steven George Dietrich | Dentist | 3500 S Kiwanis Avenue, Suite 100, Sioux Falls, SD 57105 | 2006-11-06 |
| 1063592160 | Jeffrey Herbert Wiswall | Dentist | 2525 W Main St Ste 307, Rapid City, SD 57702-2443 | 2006-10-16 |
| 1356421168 | Marshall Thomas Lavin | Dentist | 1710 S Southeastern Ave, Sioux Falls, SD 57103-3381 | 2006-10-16 |
| 1023089596 | Anne Elizabeth Wiseman | Dentist | 5110 W 26th St, Sioux Falls, SD 57106-3520 | 2006-01-31 |
| 1972101277 | Wiseman Endodontics LLC | Dentist | 5110 W 26th St, Sioux Falls, SD 57106-3520 | 2020-10-09 |
| 1902329949 | Hermanson Endodontics LLC | Dentist | 1709 N Lincoln Ave Ste 103, Pierre, SD 57501-7809 | 2017-07-21 |
| 1073985982 | Jeffrey Wiswall Dds Ms PC | Dentist | 2525 W Main St Ste 307, Rapid City, SD 57702-2443 | 2015-10-30 |
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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.