Active NPI
Taylor Christiansen, DDS
- Dentist
- Jefferson City, MO
National Provider Identifier
1205565132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2022019312
- Practice address
- 1511 Christy Dr
Jefferson City, MO 65101-2854 - Phone
- (573) 632-2777
- NPI assigned
- Jun 7, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2022019312 | MO | Primary |
Addresses
Primary practice location
1511 Christy Dr
Jefferson City, MO 65101-2854
Mailing address
2826 Valley View Ter
Jefferson City, MO 65109-1054
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220718002335 | MO | Order and Referring Only - Dentist | 2365823648 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022019312 | MO | MD | Dentist |
Interoperability endpoints
- taylor.christiansen.p1@direct.chccmo.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654560000000",
"number": "1205565132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2826 VALLEY VIEW TER",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651091054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1511 CHRISTY DR",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651012854",
"telephone_number": "573-632-2777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTIANSEN",
"first_name": "TAYLOR",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-07",
"last_updated": "2022-06-07",
"certification_date": "2022-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2022019312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.