Individual provider Active NPI

Christopher Michael Hormuth, DDS

  • Dentist
  • Saint Paul, MN
National Provider Identifier
1912230285
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D12696 Issued in MN
Practice address
1790 7TH St E
Saint Paul, MN 55119-3419
Phone
(651) 735-0595
Fax
(651) 735-0521
NPI assigned
Sep 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D12696 MN Primary

Addresses

Primary practice location

1790 7TH St E
Saint Paul, MN 55119-3419

Mailing address

1790 7TH St E
Saint Paul, MN 55119-3419
Phone (651) 735-0595

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
D12696MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1912230285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 7TH ST E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551193419",
            "telephone_number": "651-735-0595",
            "fax_number": "651-735-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 7TH ST E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551193419",
            "telephone_number": "651-735-0595",
            "fax_number": "651-735-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORMUTH",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-17",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; 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.