Healthcare Provider Details

I. General information

NPI: 1609437326
Provider Name (Legal Business Name): KRISTEN K CRUTCHFIELD DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 07/17/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 MADISON RD
CINCINNATI OH
45208-1257
US

IV. Provider business mailing address

3101 BURNET AVE
CINCINNATI OH
45229-3014
US

V. Phone/Fax

Practice location:
  • Phone: 513-363-9110
  • Fax: 513-357-7385
Mailing address:
  • Phone: 513-357-7291
  • Fax: 513-357-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30025882
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: