Individual provider Active NPI

Christopher Judsonn Vogt, D.D.S.

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1689014029
Registry record updated Jun 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28912 Issued in TX
Practice address
9234 N Loop 1604 W
Ste 121 & 123
San Antonio, TX 78249-2983
Phone
(210) 681-1121
NPI assigned
Jun 30, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2013

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 28912 TX Primary

Addresses

Primary practice location

9234 N Loop 1604 W
Ste 121 & 123
San Antonio, TX 78249-2983

Mailing address

5419 Bright Run
San Antonio, TX 78240-2458
Phone (512) 294-4719

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
I20150804003563 TX Order and Referring Only - DentistPractitioner - Dentist 5698089720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28912TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bandera Modern Dentistry, PC Past Accepting new patients

Organizations & group practices 1

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": "1372550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372550400000",
    "number": "1689014029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5419 BRIGHT RUN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782402458",
            "telephone_number": "512-294-4719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9234 N LOOP 1604 W",
            "address_2": "STE 121 & 123",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492983",
            "telephone_number": "210-681-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOGT",
        "first_name": "CHRISTOPHER",
        "middle_name": "JUDSONN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-30",
        "last_updated": "2013-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.