Active NPI
Christine Whitaker Fordtran
- Dental Hygienist
- Missouri City, TX
National Provider Identifier
1689296154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 12789
- Practice address
- 3507 Covey Trail Dr
Missouri City, TX 77459-3003 - Phone
- (713) 894-6079
- NPI assigned
- May 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH.002025133 | CO | |
| Dental Hygienist | 124Q00000X | 12789 | TX | Primary |
Addresses
Primary practice location
3507 Covey Trail Dr
Missouri City, TX 77459-3003
Mailing address
3507 Covey Trail Dr
Missouri City, TX 77459-3003
Phone (713) 894-6079
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DH.002025133 | Other | CO | REGISTERED DENTAL HYGIENE PRACTITIONER LICENSE |
| 12789 | Other | TX | DENTAL HYGIENE PRACTITIONER LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | christine@imperialcpr.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DH.002025133 | CO | MD | Dental Hygienist |
| 12789 | TX | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682553600000",
"number": "1689296154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3507 COVEY TRAIL DR",
"city": "MISSOURI CITY",
"state": "TX",
"postal_code": "774593003",
"telephone_number": "713-894-6079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3507 COVEY TRAIL DR",
"city": "MISSOURI CITY",
"state": "TX",
"postal_code": "774593003",
"telephone_number": "713-894-6079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORDTRAN",
"first_name": "CHRISTINE",
"middle_name": "WHITAKER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-07",
"last_updated": "2023-04-27",
"certification_date": "2022-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CO",
"license": "DH.002025133",
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "TX",
"license": "12789",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED DENTAL HYGIENE PRACTITIONER LICENSE",
"identifier": "DH.002025133",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL HYGIENE PRACTITIONER LICENSE",
"identifier": "12789",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "christine@imperialcpr.com",
"affiliation": "N",
"endpointDescription": "christine@imperialcpr.com",
"address_1": "3507 Covey Trail Dr",
"city": "Missouri City",
"state": "TX",
"country_code": "US",
"postal_code": "774593003",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Missouri City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.