Provider Demographics
NPI:1114273158
Name:SHANA XAVIERA CRAWFORD-HAWKINS DDS
Entity Type:Organization
Organization Name:SHANA XAVIERA CRAWFORD-HAWKINS DDS
Other - Org Name:SHANA X. CRAWFORD, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANA
Authorized Official - Middle Name:XAVIERA
Authorized Official - Last Name:CRAWFORD-HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:980-395-1506
Mailing Address - Street 1:101 DALLAS TOWNE PLZ
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:NC
Mailing Address - Zip Code:28034-1564
Mailing Address - Country:US
Mailing Address - Phone:704-675-8667
Mailing Address - Fax:
Practice Address - Street 1:101 DALLAS TOWNE PLZ
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:NC
Practice Address - Zip Code:28034-1564
Practice Address - Country:US
Practice Address - Phone:980-395-1506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-27
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8707122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty