Individual provider Active NPI

Christopher Garrison Kleist, D.D.S.

  • General Practice Dentistry
  • Richland, WA
National Provider Identifier
1295081859
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE 60302161 Issued in WA
Practice address
750 George Washington Way
Richland, WA 99352-4247
Phone
(509) 946-1678
NPI assigned
Jul 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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 DE 60302161 WA Primary

Addresses

Primary practice location

750 George Washington Way
Richland, WA 99352-4247

Mailing address

2701 Willowbrook Ave
Richland, WA 99352-8717
Phone (509) 591-5344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20150720002771 WA Order and Referring Only - DentistPractitioner - Dentist 5799098778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE 60302161WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1295081859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 WILLOWBROOK AVE",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993528717",
            "telephone_number": "509-591-5344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 GEORGE WASHINGTON WAY",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524247",
            "telephone_number": "509-946-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIST",
        "first_name": "CHRISTOPHER",
        "middle_name": "GARRISON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-31",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE 60302161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.