Provider Demographics
NPI:1376746685
Name:EVANS, CHRISTINE JAVIER (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:JAVIER
Last Name:EVANS
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 1:12750 CARMEL COUNTRY RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2159
Mailing Address - Country:US
Mailing Address - Phone:858-755-3780
Mailing Address - Fax:858-755-4160
Practice Address - Street 1:12750 CARMEL COUNTRY RD
Practice Address - Street 2:SUITE 206
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2159
Practice Address - Country:US
Practice Address - Phone:858-755-3780
Practice Address - Fax:858-755-4160
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA273051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice