Provider Demographics
NPI:1265849426
Name:SIERRA, CRISTIAN AMADO (DMD)
Entity Type:Individual
Prefix:DR
First Name:CRISTIAN
Middle Name:AMADO
Last Name:SIERRA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 WEST MALL STE A
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4232
Mailing Address - Country:US
Mailing Address - Phone:805-466-5787
Mailing Address - Fax:805-466-6531
Practice Address - Street 1:5960 WEST MALL STE A
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4232
Practice Address - Country:US
Practice Address - Phone:805-466-5787
Practice Address - Fax:805-466-6531
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64345122300000X
TN0000010092122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist