Provider Demographics
NPI:1912567710
Name:MUSTAFA, CHRISKA N (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISKA
Middle Name:N
Last Name:MUSTAFA
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 1:7151 RICHMOND RD STE 305
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-7234
Mailing Address - Country:US
Mailing Address - Phone:757-258-7778
Mailing Address - Fax:
Practice Address - Street 1:13860 RAISED ANTLER CIR
Practice Address - Street 2:STE B
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-7631
Practice Address - Country:US
Practice Address - Phone:804-739-6163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401416531122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist