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NPI Code Detail

MEDICARE: CHRISTINA LEWIS DDS PC

MEDICARE: CHRISTINA LEWIS DDS PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry4949NV

General Provider Information

NPI Number : 1396845590
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHRISTINA LEWIS DDS PC
Provider Business Mailing Address
First Line : 32885 SAND PIPER DR
Second Line :
City : ROMULUS
State : MI
Zip : 48174-4395
Country : US
Telephone Number : 734-728-1621
Fax Number :
Provider Business Practice Location Address
First Line : 4760 S PECOS RD
Second Line : #103
City : LAS VEGAS
State : NV
Zip : 89121-5828
Country : US
Telephone Number : 623-434-9343
Fax Number : 623-321-6268
Authorized Official
Title or Position : CREDENTIALING COORDINATOR
Name : RACHEL RAZO
Credential :
Telephone Number : 623-434-9343
Provider Enumeration Date : 09/25/2006
Last Update Date : 08/22/2020

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Directions to “CHRISTINA LEWIS DDS PC ” Practice Location

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