Provider Demographics
NPI:1174559405
Name:CRUMBAKER, JAMES J (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:CRUMBAKER
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:85 WASHINGTON ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-4297
Mailing Address - Country:US
Mailing Address - Phone:802-476-7162
Mailing Address - Fax:802-476-7120
Practice Address - Street 1:85 WASHINGTON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-4297
Practice Address - Country:US
Practice Address - Phone:802-476-7162
Practice Address - Fax:802-476-7120
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016-00020291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1006389Medicaid