DR. JOHN MAX CRESTETTO DDSMD NPI 1063597375

NPI Information

  • NPI: 1063597375
  • Provider Name: DR. JOHN MAX CRESTETTO, DDS,MD
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 901 N WINSTEAD AVE
    SUITE 130
    ROCKY MOUNT, NC
    ZIP 27804
  • Phone: (252) 443-7331

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NPI Details

DR. John Max Crestetto, DDS,MD is an oral and maxillofacial surgery dentist in Rocky Mount, NC. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. John Max Crestetto, DDS,MD NPI is 1063597375. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

901 N WINSTEAD AVE
SUITE 130
ROCKY MOUNT, NC
ZIP 27804-467
Phone: (252) 443-7331
Fax: (252) 937-2381

The NPI 1063597375 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 10/26/2006 and was last updated on 2/20/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery6759NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12470371MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA
20102XMEDICAIDNORTH CAROLINA
3U66515MEDICARE UPINNORTH CAROLINA
48990023MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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