Provider Demographics
NPI:1861497885
Name:CHRISTENSEN, STEVEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 SW CHANDLER AVE
Mailing Address - Street 2:STE 202
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3240
Mailing Address - Country:US
Mailing Address - Phone:541-389-3073
Mailing Address - Fax:541-389-9642
Practice Address - Street 1:1475 SW CHANDLER AVE
Practice Address - Street 2:STE 202
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3240
Practice Address - Country:US
Practice Address - Phone:541-389-3073
Practice Address - Fax:541-389-9642
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR83941223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR233062Medicaid