DR. MICHAEL RAYMOND CRADDOCK DDS NPI 1871541276

NPI Information

NPI: 1871541276
Provider Name: DR. MICHAEL RAYMOND CRADDOCK, DDS
Classification: Dentist - 1223P0700X
Specialization: Prosthodontics
Entity Type: Individual
PECOS Registration: Yes
Address: 2050A 2ND ST SE
KIRTLAND AFB, NM
ZIP 87117
Phone: (505) 846-3200

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NPI Details

DR. Michael Raymond Craddock, DDS is a prosthodontics dentist in Kirtland Afb, NM. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. DR. Michael Raymond Craddock, DDS NPI is 1871541276. 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:

2050A 2ND ST SE
KIRTLAND AFB, NM
ZIP 87117-901
Phone: (505) 846-3200

The NPI 1871541276 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 5/5/2006 and was last updated on 4/14/2021.

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
1	122300000X	Dentist		DEN.00009325	COLORADO	No
2	122300000X	Dentist		DD5009	NEW MEXICO	No
3	1223G0001X	Dentist	General Practice	14481	TEXAS	No
4	1223P0700X	Dentist	Prosthodontics	DEN.00009325	COLORADO	Yes
5	1223P0700X	Dentist	Prosthodontics	14481	TEXAS	No

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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