Individual provider Active NPI

Samuel Christensen, D.D.S, M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Ankeny, IA
National Provider Identifier
1962745471
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
09175 Issued in IA
Practice address
2575 N Ankeny Blvd Ste 205
Ankeny, IA 50023-4710
Phone
(515) 965-2672
NPI assigned
Apr 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 09175 IA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 09175 IA Primary

Addresses

Primary practice location

2575 N Ankeny Blvd Ste 205
Ankeny, IA 50023-4710

Mailing address

2575 N Ankeny Blvd Ste 205
Ankeny, IA 50023-4710
Phone (515) 965-2672

Other practice location 1

201 Dental Science S
Iowa City, IA 52242-1001
Phone (319) 335-7485

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
09175IAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1962745471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 N ANKENY BLVD STE 205",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500234710",
            "telephone_number": "515-965-2672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 N ANKENY BLVD STE 205",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500234710",
            "telephone_number": "515-965-2672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Dental Science S",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421001",
            "country_code": "US",
            "telephone_number": "319-335-7485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S, M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IA",
            "license": "09175",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IA",
            "license": "09175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.