Provider Demographics
NPI:1548567761
Name:REID, CHRISTINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:REID
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 1:6944 A ST STE B
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4112
Mailing Address - Country:US
Mailing Address - Phone:402-483-7597
Mailing Address - Fax:
Practice Address - Street 1:6944 A ST STE B
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4112
Practice Address - Country:US
Practice Address - Phone:402-483-7597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE66731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025480500Medicaid
NE04567OtherBLUE CROSS BLUE SHIELD NEBRASKA
1933939OtherUNITED CONCORDIA