Christopher David Nelson, D.D.S.
Individual provider Active NPI Dentist · Round Mountain, CA
NPI 1306179239 · NPPES record last updated Sep 10, 2009
Key facts
- NPI
- 1306179239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 58551 (CA)
- Practice address
- 29632 Highway 299 East
Round Mountain, CA 96084 - Phone
- (530) 337-5750
- Fax
- (530) 337-5754
- NPI assigned
- Sep 10, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160525001671 | CA | Order and Referring Only - Dentist |
9234428699 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58551 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chris Nelson DDS a Professional Corporation | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 58551 | CA | Yes |
Addresses
Primary practice location
29632 Highway 299 East
Round Mountain, CA 96084
Mailing address
PO Box 228
Round Mountain, CA 96084-0228
Phone (530) 337-5750
Other providers in Round Mountain, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.