Christopher Eric Wacker, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

43267 Issued in CA

Practice address

25884 Business Center Drive #F
Redlands, CA 92374

Phone

(909) 796-2507

Fax

(909) 796-3247

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Loma Linda Children'S Dental Group

  • Pediatric Dentistry
  • Loma Linda, CA
  • NPI 1750435368
  NPD (past) Authorized official

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1609894864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25884 BUSINESS CENTER DRIVE #F",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92374",
            "telephone_number": "909-796-2507",
            "fax_number": "909-796-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25884 BUSINESS CENTER DRIVE #F",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92374",
            "telephone_number": "909-796-2507",
            "fax_number": "909-796-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACKER",
        "first_name": "CHRISTOPHER",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "43267",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "43267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "900136449",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "855677",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vista Guidance Centers, Inc.
• Dan Bich Thi Vo, DO
• Stacy Kimtho Vo, O.D
• Michael Volkov, RN
• Tom Vu, MS
• Clare Aurora Wada, DO
• Jonathan Waggonner, PTA, CMT
• Gerrit Lee Wagner, D.C., L.AC
• Stephanie Waidner
• Shannon Harris Wailes, DDS

• Dentist in Redlands, CA
• Providers in Redlands, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.