Todd Patrick Christianson, DDS
Individual provider Active NPI General Practice Dentistry · Waseca, MN
NPI 1104085380 · NPPES record last updated Apr 3, 2012
Key facts
- NPI
- 1104085380
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D12531 (MN)
- Practice address
- 118 State St N
Waseca, MN 56093-2929 - Phone
- (507) 835-4280
- NPI assigned
- Jun 3, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151112002057 | MN | Order and Referring Only - Oral Surgery |
3072823533 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Todd P. Christianson P.C. | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D12531 | MN | Yes |
Addresses
Primary practice location
118 State St N
Waseca, MN 56093-2929
Mailing address
118 State St N
Waseca, MN 56093-2929
Phone (507) 835-4280
Other providers in Waseca, MN
- Samantha Boyer
- Ryan Craig Buchele
- Jay Riley Bulfer
- Kirsten Carey
- Jill Elizabeth Christensen
- Compassionate Counseling Services
- County of Waseca
- Robert Paul Daschner
- Christine Dauck
- Kelsie Josephine Davis
All providers in Waseca, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.