Individual provider Active NPI

Christopher William Proctor, DDS

  • General Practice Dentistry
  • Abilene, TX
National Provider Identifier
1063503548
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20552 Issued in TX
Practice address
4601 Buffalo Gap Rd
Suite C-4
Abilene, TX 79606-3375
Phone
(325) 692-2423
Fax
(325) 692-2076
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20552 TX Primary

Addresses

Primary practice location

4601 Buffalo Gap Rd
Suite C-4
Abilene, TX 79606-3375

Mailing address

1226 Sayles Blvd
Abilene, TX 79605-4204
Phone (325) 673-6676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20552TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Dental Care PastSince Jan 15, 2023 Accepting new patients
Southwest Dental Care of Abilene, PLLC General Practice Past Accepting new patients

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063503548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 SAYLES BLVD",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796054204",
            "telephone_number": "325-673-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 BUFFALO GAP RD",
            "address_2": "SUITE C-4",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796063375",
            "telephone_number": "325-692-2423",
            "fax_number": "325-692-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "CHRISTOPHER",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.