Provider Demographics
NPI:1609437326
Name:CRUTCHFIELD, KRISTEN K (DDS)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:K
Last Name:CRUTCHFIELD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 BURNET AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3014
Mailing Address - Country:US
Mailing Address - Phone:513-357-7291
Mailing Address - Fax:513-357-7385
Practice Address - Street 1:2520 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-1257
Practice Address - Country:US
Practice Address - Phone:513-363-9110
Practice Address - Fax:513-357-7385
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30025882122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0356938Medicaid