Provider Demographics
NPI:1376626622
Name:BUONCRISTIANI, MINDY L (DDS)
Entity type:Individual
Prefix:DR
First Name:MINDY
Middle Name:L
Last Name:BUONCRISTIANI
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 1:32045 PACIFIC COAST HWY
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-2549
Mailing Address - Country:US
Mailing Address - Phone:415-497-8357
Mailing Address - Fax:
Practice Address - Street 1:1880 E TANGERINE RD STE 190
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-6239
Practice Address - Country:US
Practice Address - Phone:520-544-5590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA437641223E0200X
AZD0124251223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics