Individual provider Active NPI

Christopher John Von Tersch, DDS

  • General Practice Dentistry
  • Stockton, CA
National Provider Identifier
1831226125
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
46710 Issued in CA
Practice address
3453 Brookside Rd Ste B
Stockton, CA 95219-1788
Phone
(209) 477-0223
Fax
(209) 477-0226
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

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 46710 CA Primary

Addresses

Primary practice location

3453 Brookside Rd Ste B
Stockton, CA 95219-1788

Mailing address

6056 Riverbank Cir
Stockton, CA 95219-2522
Phone (209) 477-0223

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

LicenseStateTypeSpecialty
46710CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831226125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6056 RIVERBANK CIR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192522",
            "telephone_number": "209-477-0223",
            "fax_number": "209-477-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3453 BROOKSIDE RD STE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952191788",
            "telephone_number": "209-477-0223",
            "fax_number": "209-477-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON TERSCH",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.