Active NPI
Christopher N Sands, DDS
- General Practice Dentistry
- Waupaca, WI
National Provider Identifier
1376668715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4070-15
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150428000818 | WI | Order and Referring Only - Oral Surgery | 3173842028 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4070-15 | WI | MD | General 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.