JOHN M MCCRILLIS NPI 1184678815

NPI Information

  • NPI: 1184678815
  • Provider Name: JOHN M MCCRILLIS
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • Address: 3935 DUPONT CIR
    SUITE C
    LOUISVILLE, KY
    ZIP 40207
  • Phone: (502) 458-7476

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NPI Details

John M Mccrillis is a general practice dentist in Louisville, KY. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. John M Mccrillis NPI is 1184678815. 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:

3935 DUPONT CIR
SUITE C
LOUISVILLE, KY
ZIP 40207-824
Phone: (502) 458-7476
Fax: (502) 458-7797

The enumeration date for this NPI number is 5/19/2006 and was last updated on 5/17/2016.

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
11223G0001XDentistGeneral Practice4612KENTUCKYYes

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
1000000068357OTHERKENTUCKYANTHEM NON-PAR
25003340001MEDICARE NSCKENTUCKY
31647201MEDICARE ID-TYPE UNSPECIFIEDKENTUCKYMEDICARE PART B
4U65556MEDICARE UPINKENTUCKY

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: 3/30/2025

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