Christian R Willard, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

015330 Issued in MO

Practice address

523 State Highway 248 Ste a
Branson, MO 65616-7748

Phone

(417) 336-2404

Fax

(417) 336-4089

NPI assigned

Aug 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr Christian R D Willard,DDS,PC

  • Dentist
  • Branson, MO
  • NPI 1730381427
  NPD (past) Authorized official
• Heitman Family Dentistry LLC

  dba 248 Dental

  • General Practice Dentistry
  • Branson, MO
  • NPI 1548022296
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811003221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 STATE HIGHWAY 248 STE A",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167748",
            "telephone_number": "417-336-2404",
            "fax_number": "417-336-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 STATE HIGHWAY 248 STE A",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167748",
            "telephone_number": "417-336-2404",
            "fax_number": "417-336-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "CHRISTIAN",
        "middle_name": "R",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "015330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL ID",
            "identifier": "015330",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherilyn R Weter, CRNA
• Anthony Wheeler, MD
• Holly Lynn Wherry, MD
• White River Anesthesia Associates, Inc
• Whole Health Chiropractic, LLC
• Bryan Williams
• Tracey Lynn Williams
• Chelsie Rochelle Willson
• Danielle Wilson
• Rita Lynn Windle, MSW

• Dentist in Branson, MO
• Providers in Branson, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.