John Wendell Christophe, D.D.S.

Individual provider Active NPI General Practice Dentistry · Alexandria, LA

NPI 1922059906 · NPPES record last updated Nov 1, 2024

Key facts

NPI
1922059906
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
7629 (LA)
Practice address
2235 Worley Dr
Alexandria, LA 71301-3631
Phone
(318) 613-4652
Fax
(318) 442-2493
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
61216943WAMDGeneral Practice Dentistry
4741-015WIMDGeneral Practice Dentistry
9307COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Howell David Jones III Apdc Past
since Nov 3, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7629 LA Yes
General Practice Dentistry 1223G0001X 4741-015 WI
General Practice Dentistry 1223G0001X 9307 CO
General Practice Dentistry 1223G0001X 20800 TX
General Practice Dentistry 1223G0001X 61216943 WA

Addresses

Primary practice location

2235 Worley Dr
Alexandria, LA 71301-3631

Mailing address

2235 Worley Dr
Alexandria, LA 71301-3631
Phone (303) 507-1287

Other identifiers

IdentifierTypeStateIssuer
1275830390MedicaidTX

Other providers in Alexandria, LA

All providers in Alexandria, LA · General Practice Dentistry in Louisiana

Sources for this page

Verify at the official NPI Registry.