Christopher Jay Pfaller, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1821G Issued in WI

Practice address

1025 Third Ave.
Woodruff, WI 54568-0680

Phone

(715) 356-2777

Fax

(715) 356-9037

NPI assigned

Sep 29, 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

Medicare fee-for-service enrollment

Enrolled in WI

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.

• Ideal Dental Inc.

  • General Practice Dentistry
  • Woodruff, WI
  • NPI 1366141822
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891887295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 3RD AVE.",
            "city": "WOODRUFF",
            "state": "WI",
            "postal_code": "545680680",
            "telephone_number": "715-356-2777",
            "fax_number": "715-356-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 THIRD AVE.",
            "city": "WOODRUFF",
            "state": "WI",
            "postal_code": "545680680",
            "telephone_number": "715-356-2777",
            "fax_number": "715-356-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFALLER",
        "first_name": "CHRISTOPHER",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1821G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwoods Dentistry Woodruff LLC
• Northwoods Surgery Center, LLC
• Amy Lynn Nowak, RN
• Brenda L Osowski, PT
• Halley M Otto, PT
• Barbara Lynn Phillips, DMD
• Molly Kathryn Pilarski, M.D.
• John J Pinzl
• Premier Physical Medicine and Wellness Clinic
• Heidi Ann Pritzl, LCSW

• General Practice Dentistry in Woodruff, WI
• Providers in Woodruff, WI by specialty
• General Practice Dentistry in Wisconsin

• 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.