NPIMap

Organization Active NPI

Walter Pfitzinger, DDS, PC No. 2

Doing business as Riverside Family Dental Center

  • General Practice Dentistry
  • Jefferson City, MO
National Provider Identifier
1356588701
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
015466 Issued in MO
Legal business name
WALTER PFITZINGER, DDS, PC NO. 2
Doing business as
Riverside Family Dental Center
Practice address
214 Prodo Dr
Suite 104
Jefferson City, MO 65109-3904
Phone
(573) 893-3163
Fax
(573) 893-8629
NPI assigned
Jan 7, 2009
Last updated
Jan 7, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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

Authorized official

Name
Dr. Walter R Pfitzinger, DDS
Title
Owner
Phone
(877) 394-9994

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 015466 MO Primary
General Practice Dentistry 1223G0001X 2008006645 MO

Addresses

Primary practice location

214 Prodo Dr
Suite 104
Jefferson City, MO 65109-3904

Mailing address

214 Prodo Dr
Suite 104
Jefferson City, MO 65109-3904
Phone (573) 893-3163

Other names 1

  • Riverside Family Dental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Accent Dental Center of Clayton2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

214 Prodo Dr
Ste 104
Jefferson City, MO 65109
Phone (573) 893-3163

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231286400000",
    "number": "1356588701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 PRODO DR",
            "address_2": "SUITE 104",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651093904",
            "telephone_number": "573-893-3163",
            "fax_number": "573-893-8629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 PRODO DR",
            "address_2": "SUITE 104",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651093904",
            "telephone_number": "573-893-3163",
            "fax_number": "573-893-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER PFITZINGER, DDS, PC NO. 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-01-07",
        "status": "A",
        "authorized_official_last_name": "PFITZINGER",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "877-394-9994",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "015466",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2008006645",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Family Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 7, 2009; 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.