Provider Demographics
NPI:1669994448
Name:PHAM, CHRISTINA (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:PHAM
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 1:15791 E PROGRESS DR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-4257
Mailing Address - Country:US
Mailing Address - Phone:720-207-4201
Mailing Address - Fax:
Practice Address - Street 1:6262 S PARKER RD UNIT 300
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80016-1392
Practice Address - Country:US
Practice Address - Phone:303-690-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002032801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice