Individual provider Active NPI

Christopher T Thompson, DDS

  • Dentist
  • Mount Vernon, WA
National Provider Identifier
1679600290
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4892 Issued in WA
Practice address
2210 Kulshan View Drive
Suite 105
Mount Vernon, WA 98273
Phone
(360) 424-5175
Fax
(360) 424-5177
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4892 WA Primary

Addresses

Primary practice location

2210 Kulshan View Drive
Suite 105
Mount Vernon, WA 98273

Mailing address

2210 Kulshan View Drive
Suite 105
Mount Vernon, WA 98273
Phone (360) 424-5175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150923001594 CA Order and Referring Only - DentistPractitioner - Dentist 5799092722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25774CAMDChiropractor
4892WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679600290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 KULSHAN VIEW DRIVE",
            "address_2": "SUITE 105",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "98273",
            "telephone_number": "360-424-5175",
            "fax_number": "360-424-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 KULSHAN VIEW DRIVE",
            "address_2": "SUITE 105",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "98273",
            "telephone_number": "360-424-5175",
            "fax_number": "360-424-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "4892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.