Provider Demographics
NPI:1760167332
Name:MIKHAEL, CHRISTY (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:
Last Name:MIKHAEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 176TH TERRACE DR E
Mailing Address - Street 2:
Mailing Address - City:REDINGTON SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33708-1227
Mailing Address - Country:US
Mailing Address - Phone:813-486-5159
Mailing Address - Fax:
Practice Address - Street 1:6882 GULFPORT BLVD S
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-2108
Practice Address - Country:US
Practice Address - Phone:727-384-9655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN280871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice