Provider Demographics
NPI:1275680530
Name:HAYASHI, CHRISTINE M (DDS,MS)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:HAYASHI
Suffix:
Gender:F
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 FOREST AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-4831
Mailing Address - Country:US
Mailing Address - Phone:408-998-1193
Mailing Address - Fax:
Practice Address - Street 1:2000 FOREST AVE STE A
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4831
Practice Address - Country:US
Practice Address - Phone:408-998-1193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA412621223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics