Individual provider Active NPI

Christopher Probst, DMD

  • General Practice Dentistry
  • Frisco, TX
National Provider Identifier
1043704075
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
35817 Issued in TX
Practice address
5575 Warren Pkwy Ste 324
Frisco, TX 75034-4095
Phone
(469) 633-0550
NPI assigned
Jun 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.031693 IL
General Practice Dentistry 1223G0001X 35817 TX Primary

Addresses

Primary practice location

5575 Warren Pkwy Ste 324
Frisco, TX 75034-4095

Mailing address

4669 Reunion Dr
Plano, TX 75024-3841
Phone (262) 339-8450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019.031693ILMDGeneral Practice Dentistry
35817TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Family Dentistry PLLC Current Accepting new patients
Maple Shade Dental Bloomington LLC PastSince Mar 1, 2015 Accepting new patients

Locations

5575 Warren Pkwy
Ste 324
Frisco, TX 75034
Phone (469) 633-0550

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1043704075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4669 REUNION DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243841",
            "telephone_number": "262-339-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 WARREN PKWY STE 324",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344095",
            "telephone_number": "469-633-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROBST",
        "first_name": "CHRISTOPHER",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.031693",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.