Provider Demographics
NPI:1508232992
Name:ROCLEVITCH, CHRISTOPHER NICHOLAUS (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:NICHOLAUS
Last Name:ROCLEVITCH
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 1:6329 ORAM ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-3931
Mailing Address - Country:US
Mailing Address - Phone:214-823-1638
Mailing Address - Fax:214-823-1169
Practice Address - Street 1:4828 OLD SPANISH TRL # A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-1721
Practice Address - Country:US
Practice Address - Phone:210-789-1101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2023-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX316061223S0112X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist