MEDICARE: DR. CARMEN BRICENO CRESPI DMD, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN17079	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598917387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARMEN BRICENO CRESPI DMD, MS

Provider Business Mailing Address
First Line	:	8024 NW 154TH ST
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5814
Country	:	US
Telephone Number	:	305-820-6800
Fax Number	:

Provider Business Practice Location Address
First Line	:	8024 NW 154TH ST
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5814
Country	:	US
Telephone Number	:	305-820-6800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2008
Last Update Date	:	07/08/2013

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