Christopher John Edgerton, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55552 Issued in CA

Practice address

216 Traffic Way
Arroyo Grande, CA 93420-3335

Phone

(805) 709-3535

Fax

(805) 489-3944

NPI assigned

Jul 11, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1295933208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 TRAFFIC WAY",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934203335",
            "telephone_number": "805-709-3535",
            "fax_number": "805-489-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 TRAFFIC WAY",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934203335",
            "telephone_number": "805-709-3535",
            "fax_number": "805-489-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGERTON",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen A Doody, P.T.
• Zehra Dos Santos
• Juri Dowell, BCBA
• Matthew Richard Dupont, DPT
• Nathan B Ecklund, DPM
• John Eugene Edgerton, DDS
• Julia Marlys Edgerton, DDS
• Colstyn R Edwards, LMFT
• Alisha L Eftekhari
• Rami Elattar, RPH, BCOP

• General Practice Dentistry in Arroyo Grande, CA
• Providers in Arroyo Grande, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.