Healthcare Provider Details

I. General information

NPI: 1295709632
Provider Name (Legal Business Name): CHRISTINE LYNN OGDEN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINE LYNN CERAR DMD

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 03/07/2023
Certification Date: 04/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 EDWIN DR STE 200
VIRGINIA BEACH VA
23462-4545
US

IV. Provider business mailing address

329 EDWIN DR STE 200
VIRGINIA BEACH VA
23462-4545
US

V. Phone/Fax

Practice location:
  • Phone: 757-499-9839
  • Fax: 757-499-9839
Mailing address:
  • Phone: 757-499-9839
  • Fax: 757-499-9839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number0401412381
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: