Tyler C Christopherson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6947-15 Issued in WI

Practice address

3504 E Maria Dr
Stevens Point, WI 54481-1334

Phone

(715) 342-8060

Fax

(715) 342-0062

NPI assigned

Jun 26, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1245594175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3504 E MARIA DR",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811334",
            "telephone_number": "715-342-8060",
            "fax_number": "715-342-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 E MARIA DR",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811334",
            "telephone_number": "715-342-8060",
            "fax_number": "715-342-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHERSON",
        "first_name": "TYLER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6947-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Chrisinger
• Donna Y Christensen
• Alexis Lynn Christman, COTA
• Christopherson Family Dentistry LLC
• Brad W. Christopherson, OD
• Cherie Cisewski
• Clara a. Cleve
• Clara A. Cleve, MSSW
• Jay C Cleve, PHD
• Clinical Life Labs LLC

• Dentist in Stevens Point, WI
• Providers in Stevens Point, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.

Verify at the official NPI Registry.