# J MATTHEW CRONKHITE DDS PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003296955
- **Authorized official:** MARTI STICHTER (OFFICE MANAGER)
- **Authorized official phone:** (765) 471-6025

## Contact information

- **Practice address:** 3667 BRADDOCK DR STE B, LAFAYETTE, IN 47909-7302
- **Practice address phone:** (765) 471-6025
- **Mailing address:** 3667 BRADDOCK DR STE B, LAFAYETTE, IN 47909-7302
- **Mailing address phone:** (765) 471-6025

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12010734A | IN | Yes |

## Other

- **Enumeration date:** 06/05/2015
- **Last updated:** 06/05/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200860550 | — | IN |