Provider Demographics
NPI:1235741315
Name:SMITH, CHRISTINA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 CARROLLTON AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-1809
Mailing Address - Country:US
Mailing Address - Phone:504-428-8879
Mailing Address - Fax:
Practice Address - Street 1:2240 VETERANS MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062-5673
Practice Address - Country:US
Practice Address - Phone:504-405-3870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA71301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice