Provider Demographics
NPI:1245378629
Name:HIXON, CHRISTINE (RDH)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:HIXON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3708 E KACHINA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-2515
Mailing Address - Country:US
Mailing Address - Phone:480-496-9091
Mailing Address - Fax:
Practice Address - Street 1:6655 S RURAL RD STE 1
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3793
Practice Address - Country:US
Practice Address - Phone:480-831-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1894124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist