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General NPI Number Information
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NPI Number | 1144548306
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Entity Type | Individual
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Provider Name | TIFFANY MADISON CHRISTENSEN DDS
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Gender | Female
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Dates
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Enumeration Date | 05/12/2010
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Last Update Date | 07/28/2021
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Provider Practice Location Address
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Address Line | 4 DEARFIELD DR STE 204
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City | GREENWICH
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State | CT
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Zip | 06831-5351
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Country | US
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Telephone | 203-869-2044
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Fax |
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Provider Business Mailing Address
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Address Line | 56 LONG MEADOW RD
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City | RIVERSIDE
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State | CT
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Zip | 06878-1124
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Country | US
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Telephone | 917-748-2492
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02375200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 010220
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License Number State | CT
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