Provider Demographics
NPI:1568497063
Name:LIENAU, CHRIUSTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRIUSTOPHER
Middle Name:
Last Name:LIENAU
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 1:4131 NORTH 32ND STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PHOENIX
Mailing Address - State:AR
Mailing Address - Zip Code:85018
Mailing Address - Country:US
Mailing Address - Phone:602-956-0740
Mailing Address - Fax:602-956-0852
Practice Address - Street 1:4131 NORTH 32ND STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:PHOENIX
Practice Address - State:AR
Practice Address - Zip Code:85018
Practice Address - Country:US
Practice Address - Phone:602-956-0740
Practice Address - Fax:602-956-0852
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2436122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist