Individual provider Active NPI

Blane Christman, DDS

  • Dentist
  • Chippewa Falls, WI
National Provider Identifier
1861591398
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4080 Issued in WI
Practice address
425 West Prairie View Road
Chippewa Falls, WI 54729-3389
Phone
(715) 726-1060
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4080 WI Primary

Addresses

Primary practice location

425 West Prairie View Road
Chippewa Falls, WI 54729-3389

Mailing address

425 W Prairie View Road
Chippewa Falls, WI 54729-3389
Phone (715) 726-1060

Other identifiers 1

IdentifierTypeStateIssuer
33688600MedicaidWI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4080WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1861591398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W PRAIRIE VIEW ROAD",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547293389",
            "telephone_number": "715-726-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 WEST PRAIRIE VIEW ROAD",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547293389",
            "telephone_number": "715-726-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTMAN",
        "first_name": "BLANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33688600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chippewa Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; 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.