Healthcare Provider Details

I. General information

NPI: 1720912355
Provider Name (Legal Business Name): DAWN CROOKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 N MAIN ST
NEW LEXINGTON OH
43764-1264
US

IV. Provider business mailing address

303 DALLAS AVE
NEW LEXINGTON OH
43764-1406
US

V. Phone/Fax

Practice location:
  • Phone: 740-899-7189
  • Fax:
Mailing address:
  • Phone: 740-342-1991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License NumberOCPSA.162595
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: