Individual provider Active NPI

Christopher Richard Stilwill, DDS

  • Dentist
  • East Lansing, MI
National Provider Identifier
1467683193
Registry record updated Jul 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020097 Issued in MI
Practice address
6020 N Hagadorn Rd
East Lansing, MI 48823-2243
Phone
(517) 351-3122
Fax
(517) 351-3505
NPI assigned
Jul 29, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020097 MI Primary

Addresses

Primary practice location

6020 N Hagadorn Rd
East Lansing, MI 48823-2243

Mailing address

6020 N Hagadorn Rd
East Lansing, MI 48823-2243
Phone (517) 351-3122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160111000724 MI Order and Referring Only - DentistPractitioner - Dentist 7113229931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020097MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248825600000",
    "number": "1467683193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 N HAGADORN RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488232243",
            "telephone_number": "517-351-3122",
            "fax_number": "517-351-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 N HAGADORN RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488232243",
            "telephone_number": "517-351-3122",
            "fax_number": "517-351-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILWILL",
        "first_name": "CHRISTOPHER",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-29",
        "last_updated": "2009-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.