=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629413133
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINA TSENG
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2013
-----------------------------------------------------
Last Update Date | 06/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1620 N US HIGHWAY 1 STE 6
-----------------------------------------------------
City | TEQUESTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33469-3241
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-744-0677
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9037 SW LEATHER FERN WAY
-----------------------------------------------------
City | PALM CITY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34990-4136
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | DN20839
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------