Walter Robert Pfitzinger, D.D.S, M.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

10435 Issued in MO

Practice address

1500 Vandiver Dr
Ste 104
Columbia, MO 65202-3932

Phone

(573) 814-1694

Fax

(573) 814-2845

NPI assigned

Jun 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Dental Wellness Partners LLC

  dba Accent Dental Center

  • General Practice Dentistry
  • Columbia, MO
  • NPI 1407627409
  NPD
• Bridgeport Dental Services, Inc.

  • Health Maintenance Organization
  • Saint Charles, MO
  • NPI 1225274681
  NPD (past)
• Michael S. Todd D.M.D., LLC

  • General Practice Dentistry
  • Columbia, MO
  • NPI 1053568865
  NPD (past)
• Walter R. Pfitzinger D.D.S,, P.C.

  dba Mid Missouri Dental Center

  • Pediatric Dentistry
  • Columbia, MO
  • NPI 1164622395
  NPD (past)

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1770588972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WESTBURY DR",
            "address_2": "STE D",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012543",
            "telephone_number": "636-925-2787",
            "fax_number": "636-925-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 VANDIVER DR",
            "address_2": "STE 104",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652023932",
            "telephone_number": "573-814-1694",
            "fax_number": "573-814-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFITZINGER",
        "first_name": "WALTER",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S, M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "10435",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "MO",
            "license": "10435",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "10435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica L Peuterbaugh, DNP. FNP
• Daniel Kevin Peyser, M.D.
• Amy Renee Pfeiffer, PSY.D.
• Kimberley Sue Pfeiffer, FNP-C
• Eric E Pfitzinger, CRNA
• Andrew Pham, MD
• Mai Tuyet Pham, MD
• Ly T Phan, MD
• Thanh Phan
• Pharmd Solutions, LLC

• Oral and Maxillofacial Surgery (Dentist) in Columbia, MO
• Providers in Columbia, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.