Individual provider Active NPI

Chris Buchanan Gardner, DDS

  • Dentist
  • Bossier City, LA
National Provider Identifier
1144327305
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3547 Issued in LA
Practice address
1608 Jimmie Davis Hwy
Suite C
Bossier City, LA 71112-4559
Phone
(318) 747-6440
Fax
(318) 747-1524
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Dentist 122300000X 3547 LA Primary

Addresses

Primary practice location

1608 Jimmie Davis Hwy
Suite C
Bossier City, LA 71112-4559

Mailing address

1608 Jimmie Davis Hwy
Suite C
Bossier City, LA 71112-4559
Phone (318) 747-6440

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
3547LAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144327305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 JIMMIE DAVIS HWY",
            "address_2": "SUITE C",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711124559",
            "telephone_number": "318-747-6440",
            "fax_number": "318-747-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 JIMMIE DAVIS HWY",
            "address_2": "SUITE C",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711124559",
            "telephone_number": "318-747-6440",
            "fax_number": "318-747-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "CHRIS",
        "middle_name": "BUCHANAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "3547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.