Individual provider Active NPI

Christopher Nicholas Liontas, DDS

  • General Practice Dentistry
  • Pueblo West, CO
National Provider Identifier
1144482191
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9709 Issued in CO
Practice address
360 S. Orchard Springs Dr
Pueblo West, CO 81007
Phone
(719) 547-3737
Fax
(719) 547-4949
NPI assigned
Jul 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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 9709 CO Primary

Addresses

Primary practice location

360 S. Orchard Springs Dr
Pueblo West, CO 81007

Mailing address

360 S. Orchard Springs Dr.
Pueblo West, CO 81007
Phone (719) 547-3737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160210000588 CO Order and Referring Only - DentistPractitioner - Dentist 9830493980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9709COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1144482191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 S. ORCHARD SPRINGS DR.",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "81007",
            "telephone_number": "719-547-3737",
            "fax_number": "719-547-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S. ORCHARD SPRINGS DR",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "81007",
            "telephone_number": "719-547-3737",
            "fax_number": "719-547-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIONTAS",
        "first_name": "CHRISTOPHER",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo West, CO

Sources for this page

Verify at the official NPI Registry.