Provider Demographics
NPI:1982197448
Name:CHANDLER, KRISTINA LEE (DDS)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:LEE
Last Name:CHANDLER
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 1:8650 SOUTHWESTERN BLVD APT 2916
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-2691
Mailing Address - Country:US
Mailing Address - Phone:972-904-2965
Mailing Address - Fax:
Practice Address - Street 1:8755 PRESTON RD STE 310
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5696
Practice Address - Country:US
Practice Address - Phone:214-705-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-10
Last Update Date:2018-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33977122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist