Provider Demographics
NPI:1275901456
Name:TYLER M. CHRISTENSEN, DDS, P.C.
Entity Type:Organization
Organization Name:TYLER M. CHRISTENSEN, DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-331-2121
Mailing Address - Street 1:10521 JEFFREYS ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4180
Mailing Address - Country:US
Mailing Address - Phone:702-331-2121
Mailing Address - Fax:702-331-1616
Practice Address - Street 1:10521 JEFFREYS ST
Practice Address - Street 2:SUITE 200
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4180
Practice Address - Country:US
Practice Address - Phone:702-331-2121
Practice Address - Fax:702-331-1616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4770122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty