Individual provider Active NPI

Christian Adea, DDS

  • General Practice Dentistry
  • Amarillo, TX
National Provider Identifier
1639783707
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36499 Issued in TX
Practice address
1915 S Washington St Ste 100
Amarillo, TX 79109-2459
Phone
(806) 553-8400
NPI assigned
Sep 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 36499 TX Primary

Addresses

Primary practice location

1915 S Washington St Ste 100
Amarillo, TX 79109-2459

Mailing address

8976 Forest Lake Dr
Montgomery, TX 77316-6902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210908001956 TX Order and Referring Only - DentistPractitioner - Dentist 8729484274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Abbeville Dentistry - Washington St PLLC General Practice PastSince Oct 31, 2021 Accepting new patients
Tomball Smiles Dentistry, PC General Practice PastSince Sep 1, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1639783707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8976 FOREST LAKE DR",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773166902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 S WASHINGTON ST STE 100",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791092459",
            "telephone_number": "806-553-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEA",
        "first_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-04",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "36499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.