Individual provider Active NPI

Christopher William Arbuckle, DDS

  • General Practice Dentistry
  • Jefferson City, MO
National Provider Identifier
1801097191
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2006013508 Issued in MO
Practice address
214 Prodo Dr
Suite 104
Jefferson City, MO 65109-3904
Phone
(573) 893-3476
Fax
(573) 893-8629
NPI assigned
May 31, 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
General Practice Dentistry 1223G0001X 2006013508 MO Primary

Addresses

Primary practice location

214 Prodo Dr
Suite 104
Jefferson City, MO 65109-3904

Mailing address

6270 Breezewood Dr
Columbia, MO 65202-9688
Phone (573) 514-4900

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210115001421 MO Order and Referring Only - DentistPractitioner - Dentist 4385057140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Walter Pfitzinger, DDS, PC No. 2 General Practice 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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801097191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6270 BREEZEWOOD DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652029688",
            "telephone_number": "573-514-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 PRODO DR",
            "address_2": "SUITE 104",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651093904",
            "telephone_number": "573-893-3476",
            "fax_number": "573-893-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARBUCKLE",
        "first_name": "CHRISTOPHER",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2006013508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.