Provider Demographics
NPI:1467672113
Name:GIPE, CHRIS ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:ALLEN
Last Name:GIPE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3532 HOWARD AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3681
Mailing Address - Country:US
Mailing Address - Phone:562-431-1349
Mailing Address - Fax:562-598-1775
Practice Address - Street 1:3532 HOWARD AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3681
Practice Address - Country:US
Practice Address - Phone:562-431-1349
Practice Address - Fax:562-598-1775
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA285571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice