Provider Demographics
NPI:1831701622
Name:RIOS, CHRISTINA ELAINE (DMD)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ELAINE
Last Name:RIOS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 SW 87TH TER APT 1801
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-6645
Mailing Address - Country:US
Mailing Address - Phone:786-355-6724
Mailing Address - Fax:
Practice Address - Street 1:2930 SW 87TH TER APT 1801
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-6645
Practice Address - Country:US
Practice Address - Phone:786-355-6724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice