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General NPI Number Information
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NPI Number | 1629111901
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Entity Type | Individual
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Provider Name | TANIA NELSON-CHRYSTAL DDS, MD
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Gender | Female
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 8775 SIERRA COLLEGE BLVD STE 350
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City | ROSEVILLE
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State | CA
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Zip | 95661-5986
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Country | US
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Telephone | 916-262-7963
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Fax |
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Provider Business Mailing Address
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Address Line | 3671 CAMINO CIELO
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City | LINCOLN
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State | CA
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Zip | 95648-7951
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Country | US
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Telephone | 443-519-6540
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Fax | 916-244-2714
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 59442
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License Number State | CA
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