Provider Demographics
NPI:1285669572
Name:MAI, CHRISTINE L (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:L
Last Name:MAI
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 1:6422 GROVEDALE DR
Mailing Address - Street 2:STE 101A
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-2570
Mailing Address - Country:US
Mailing Address - Phone:703-971-9737
Mailing Address - Fax:703-971-4446
Practice Address - Street 1:6422 GROVEDALE DR
Practice Address - Street 2:STE 101A
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-2570
Practice Address - Country:US
Practice Address - Phone:703-971-9737
Practice Address - Fax:703-971-4446
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010087441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice