Provider Demographics
NPI:1306856364
Name:DO, CHRISTINA THANH (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:THANH
Last Name:DO
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 1:1530 BAKER ST STE J
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-3752
Mailing Address - Country:US
Mailing Address - Phone:714-557-0700
Mailing Address - Fax:
Practice Address - Street 1:1530 BAKER ST STE J
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-3752
Practice Address - Country:US
Practice Address - Phone:714-557-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52376122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist