Individual provider Active NPI

Christopher N Sands, DDS

  • General Practice Dentistry
  • Waupaca, WI
National Provider Identifier
1376668715
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4070-15 Issued in WI
Practice address
701 Riverside Drive
Riverhill Dental Associates
Waupaca, WI 54981
Phone
(715) 258-3311
Fax
(715) 258-4104
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4070 MN
General Practice Dentistry 1223G0001X 4070-15 WI Primary

Addresses

Primary practice location

701 Riverside Drive
Riverhill Dental Associates
Waupaca, WI 54981

Mailing address

701 Riverside Drive
Waupaca, WI 54981
Phone (715) 258-3311

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150428000818 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3173842028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4070-15WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1376668715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 RIVERSIDE DRIVE",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "54981",
            "telephone_number": "715-258-3311",
            "fax_number": "715-258-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 RIVERSIDE DRIVE",
            "address_2": "RIVERHILL DENTAL ASSOCIATES",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "54981",
            "telephone_number": "715-258-3311",
            "fax_number": "715-258-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDS",
        "first_name": "CHRISTOPHER",
        "middle_name": "N",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "4070",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4070-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waupaca, WI

Sources for this page

Verify at the official NPI Registry.