Dr Michael Raymond Craddock, DDS in Kirtland Afb, NM

Dr Michael Raymond Craddock, DDS is a medicare enrolled "Dentist - Prosthodontics" provider in Kirtland Afb, New Mexico. His current practice location is 2050a 2nd St Se, Kirtland Afb, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 846-3200.

Dr Michael Raymond Craddock is licensed to practice in Colorado (license number DEN.00009325) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1871541276.

Contact Information

	Dr Michael Raymond Craddock, DDS
	2050a 2nd St Se, Kirtland Afb, NM 87117-5901
	(505) 846-3200
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Michael Raymond Craddock
Gender	Male
Speciality	Dentist - Prosthodontics
Location	2050a 2nd St Se, Kirtland Afb, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1871541276
Provider Enumeration Date: 05/05/2006
Last Update Date: 04/14/2021

Medicare PECOS Information:

PECOS PAC ID: 1951764497
Enrollment ID: I20230830003412

Medical Identifiers

Medical identifiers for Dr Michael Raymond Craddock such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1871541276	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	DD5009 (New Mexico)	Secondary
1223G0001X	Dentist - General Practice	14481 (Texas)	Secondary
1223P0700X	Dentist - Prosthodontics	14481 (Texas)	Secondary
1223P0700X	Dentist - Prosthodontics	DEN.00009325 (Colorado)	Primary
122300000X	Dentist	DEN.00009325 (Colorado)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Michael Raymond Craddock allows following entities to bill medicare on his behalf.

Entity Name	Canoncito Band Of Navajos Health Center, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1578010070 PECOS PAC ID: 8325321235 Enrollment ID: O20170425001197

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Michael Raymond Craddock is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Michael Raymond Craddock, DDS 2050a 2nd St Se, Kirtland Afb, NM 87117-1823 Ph: (719) 502-0612	Dr Michael Raymond Craddock, DDS 2050a 2nd St Se, Kirtland Afb, NM 87117-5901 Ph: (505) 846-3200

Reviews and Comments

Dentist in Kirtland Afb, NM

Dr. Lynn Michael Johnson, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050 2nd St Se, Kirtland Afb, NM 87117 Phone: 505-846-2466
Brett Mason Harrell, Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050a 2nd St Se, Kirtland Afb, NM 87117 Phone: 937-818-5346
Satpal S Jutla, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050a 2nd St Se, Kirtland Afb, NM 87117 Phone: 505-846-3200
Ronald Nelson, Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050a Second Street Se, Kirtland Afb, NM 87117 Phone: 505-846-2607
Dr. John Keith Paul Iii, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050 A Second St. Se, 377 Mdg, Kirtland Afb, NM 87117 Phone: 505-846-3055
Mariah Gordon, Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050a 2nd St Se, Kirtland Afb, NM 87117 Phone: 505-846-3200
Dr. Steven C. Fenzl, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 377 Dental Sq/sgd, 2050a 2nd St Se, Kirtland Afb, NM 87117 Phone: 505-846-2548 Fax: 505-846-2428

Dr Michael Raymond Craddock, DDS - Medicare Dentist in Kirtland Afb, NM