Provider Demographics
NPI:1437425105
Name:DIXON, CHRISTINA (RDHAP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:DIXON
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-2576
Mailing Address - Country:US
Mailing Address - Phone:415-725-2515
Mailing Address - Fax:415-358-0494
Practice Address - Street 1:672 PEACH ST
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-2576
Practice Address - Country:US
Practice Address - Phone:415-725-2515
Practice Address - Fax:415-358-0494
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA382124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist