Healthcare Provider Details

I. General information

NPI: 1013062876
Provider Name (Legal Business Name): CHRISTOPHER ALAN MANGOLD DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 BARTLETT STE B
EL PASO TX
79912
US

IV. Provider business mailing address

201 BARTLETT STE B
EL PASO TX
79912
US

V. Phone/Fax

Practice location:
  • Phone: 915-584-4497
  • Fax: 915-584-1031
Mailing address:
  • Phone: 915-584-4497
  • Fax: 915-584-1031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13365
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: