Healthcare Provider Details

I. General information

NPI: 1013883479
Provider Name (Legal Business Name): KEVIN CROFT DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 RIVERSIDE DR
DANVILLE VA
24541-5152
US

IV. Provider business mailing address

PO BOX 522354
SALT LAKE CITY UT
84152-2354
US

V. Phone/Fax

Practice location:
  • Phone: 801-477-5337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number
License Number State

VIII. Authorized Official

Name: KEVIN CROFT
Title or Position: OWNER
Credential: DDS
Phone: 801-477-5337