Provider Demographics
NPI:1831484351
Name:MEYERS, CHRISTIAN OGURA (DDS)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:OGURA
Last Name:MEYERS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CHRISTIAN
Other - Middle Name:FRANCES
Other - Last Name:OGURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:70 W MERCURY BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-2570
Mailing Address - Country:US
Mailing Address - Phone:757-722-2929
Mailing Address - Fax:
Practice Address - Street 1:70 W MERCURY BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-2570
Practice Address - Country:US
Practice Address - Phone:757-722-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413229122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist