MEDICARE: DR. CHRISTOPHER JOSEPH VANKESTEREN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	21923	TX
2	1223P0300X	Periodontics	8561	NC
3	1223P0300X	Periodontics	260078	NC

General Provider Information

NPI Number	:	1063683092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER JOSEPH VANKESTEREN D.D.S.

Provider Business Mailing Address
First Line	:	2315 W ARBORS DR
Second Line	:	SUITE 100
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-2577
Country	:	US
Telephone Number	:	704-549-4991
Fax Number	:	704-549-0135

Provider Business Practice Location Address
First Line	:	2315 W ARBORS DR
Second Line	:	SUITE 100
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-2577
Country	:	US
Telephone Number	:	704-549-4991
Fax Number	:	704-549-0135

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2008
Last Update Date	:	05/01/2025

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