Provider Demographics
NPI:1144227240
Name:VY, CHRISTINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:VY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12661 SE POWELL BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-3400
Mailing Address - Country:US
Mailing Address - Phone:503-762-2500
Mailing Address - Fax:503-762-2504
Practice Address - Street 1:12661 SE POWELL BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97236-3400
Practice Address - Country:US
Practice Address - Phone:503-762-2500
Practice Address - Fax:503-762-2504
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD76311223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics