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General NPI Number Information
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NPI Number | 1679762728
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Entity Type | Individual
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Provider Name | DONALD RICHARD CHRISTIANSEN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/15/2007
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Last Update Date | 11/14/2020
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Provider Practice Location Address
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Address Line | 3285 S VAL VISTA DR
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City | GILBERT
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State | AZ
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Zip | 85297-7000
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Country | US
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Telephone | 480-397-2860
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Fax |
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Provider Business Mailing Address
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Address Line | 7228 E PAMPA AVE
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City | MESA
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State | AZ
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Zip | 85212-9795
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Country | US
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Telephone | 702-358-9987
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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 | 6143
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7323
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License Number State | AZ
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